assessment tools in community neuro

[annawilko]

Hi,

I work in a community neuro rehab team and we are trying to develop a new assessment form which will be suitable for the majority of our patients.

Does anyone have anything they already use or could suggest somewhere to start looking?
We have lots of outcome measures already in place but it is the layout of the assessment tool and what we need to cover on it.

Any help or examples of forms people use would be greatfully recevied!
thanks
anna

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[Fyzzio]

Hi,
we have used the ICF framework as format for our assessment and fit the outcome measures under the according aspects; e.g Health condition - SHX, past MHX, ...; Body structures and functions - fatigue, balance, oculomotor, vestibular, strength, ...; Activities- gait, transfers, ...; Participation - community ambulation, work, ...; Environmental factors - home, ...; Personal factors - coping strategies,...

WHO | International Classification of Functioning, Disability and Health (ICF)

Just one way of doing it.
regards,
Fyzzio

[gcoe]

Hi Fyzzio & annawilko

Fyzzio I think the use of the ICF to map out your assessment for community rehab an excellent strategy. The great thing about using the ICF is that it helps us get a comprehensive and holistic perspective on assessment. It is the most comprehensive framework we have used in rehab and offers lots of practical help for assessment.

It is worth noting that the ICF will give you much more detail on what to consider than these five overarching components of functioning and it might be worth having a look at what is on offer. This detail aims to provide a way of checking if your tests and measures are capturing all important points. For example under activities is a chapter on mobility. The chapter on Mobility covers sections such as changing and maintaining body position, carrying, and moving and handling objects. Each of these sections lists a multitude of categories. For example changing and maintaining body position includes changing basic body position and maintaining a body position etc. In turn these break down to even smaller tasks.

Unfortunately there is so much detail in the ICF that one tends to drown in it! The detail also doesn’t prioritise what is important for a particular condition or disability and what is important for a particular setting – eg community rehab. So the ICF has been developing what are called Core Sets which are prioritised points to include in an assessment, either for a particular condition or a particular setting.
For example there are core sets developed for things like stroke, MS, spinal cord injury. Here is example of one for stroke:

http://www.icf-research-branch.org/m...20Set%20ST.pdf

At the ICF site you can locate a number of these core sets:

ICF Research Branch/research/research but there are others in journals as well.

In choosing the value of a measure, as well as appraising its reliability and validity you can see if it covers the territory mapped out in the core sets. Here is a reference on how this can be done:

Grill, E. and G. Stucki, Scales could be developed based on simple clinical ratings of International Classification of Functioning, Disability and Health Core Set categories. Journal of Clinical Epidemiology, 2009. 62(9): p. 891-898.

You may find this all a bit theory driven but even if it is overkill for what you want it is good to understand how this is moving assessment in rehabiliation forward.