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Assessment and Intervention

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In this article

Overview

Physical and occupational therapists utilize a variety of strategies to assess and address impairments.  This article lists common complaints, assessments, and impairments.

*Note: Examples presented should not be considered exhaustive.

Fatigue (PT and OT)

Assessments

Interventions*

  • Energy effectiveness strategies
  • Aerobic exercise program
  • Equipment modifications (mobility, self-care, and ergonomic)
  • Cooling strategies
  • Environmental and behavioral modifications (home and job-site)
  • Transportation

Walking difficulties (PT)

Assessments

  • Manual Muscle Test
  • 25-foot walk
  • 6-minute walk
  • Gait analysis
  • Tinetti Assessment Tool
  • Timed-Up and Go
  • Dynamic Gait Assessment
  • Functional Gait Assessment
  • Analysis of environment and tasks
  • Vestibular and sensory/proprioceptive assessments
  • Safety evaluations

Interventions*

Weakness (PT and OT)

Assessments

  • Manual Muscle Test
  • Dynamometer; Pinch Meter
  • Five Times Sit to Stand
  • Gait analysis
  • Analysis of environment and tasks
  • Assessment of transitional movements

Interventions*

  • Exercises for deconditioning
  • Adaptive equipment
  • Environmental modifications
  • Cooling strategies

Poor balance/fall risk

Assessments

Interventions*

  • Vestibular/balance rehabilitation
  • Strength training
  • Gait training – dynamic activities
  • Supportive footwear
  • Gait assistive devices
  • Gait training
  • Behavioral modification
  • Environmental modification
  • Cooling strategies
  • Fall Prevention Program (video part 1; video part 2)

Stiffness, spasms, spasticity (PT and OT)

Assessments

  • Range of motion
  • Modified Ashworth
  • Consistent communication with neurologist regarding medical management (e.g., medications; intrathecal baclofen pump if severe)

Interventions*

  • Stretching exercise program
  • Environmental modifications
  • Cooling strategies
  • Standing frame
  • AFO
  • Positioning
  • Baclofen pump
  • See spasticity overview (.pdf)

Cognitive changes (OT)

Resource

Assessements

Interventions*

  • Instruction in compensatory strategies
  • Assistive devices and environmental modifications

Reduced manual dexterity (OT)

Assessments

Interventions*

  • Environmental modification
  • Behavioral modification
  • Voice-activated software
  • Bigger grips
  • Assistive devices
  • Stretching
  • Positioning

Pain (PT and OT)

Resource

Assessments

  • Trigger point assessment
  • Pain scales
  • Posture assessment
  • Equipment/seating assessment
  • Central vs. peripheral symptoms

Interventions*

Tremor/Ataxia (PT and OT)

Assessments

Interventions*

  • Gait assistive devices
  • Powered mobility equipment
  • Weighting; proximal stabilization
  • Behavioral modification

Sensory changes (including proprioception) (PT and OT)

Assessments

  • Proprioception
  • Semmes-Weinstein Sensory Test
  • Hot/cold discrimination

Interventions*

  • Larger grips
  • Textured surfaces
  • Supportive footwear
  • Voice-activated software
  • Sensory precautions

Poor vision (OT)

Resource

Assessments

  • Visual acuity
  • Tracking
  • Peripheral vision
  • Visual-perceptual assessment

Interventions*

  • Behavioral modification
  • Environmental modification

Decreased functional independence

Assessments

Interventions*

  • Assistive equipment
  • Powered mobility equipment
  • Behavior and environmental modifications

 

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