MSFC Assessment Paper

Recently, I have been working on analyzing the data further to examine the associations between the MRI-derived indices and cognitive impairment, as measured by components of the Multiple Sclerosis Functional

Some assessment tests that can be done to determine areas of occupational dysfunction important to the person are the Canadian Occupational Performance (COPM) interview, the Robinson Bashall Functional Assessment, the Stanford Health Assessment Questionnaire, the Assessment of Motor and Process Skills (AMPS), manual muscle tests, the goniometer, and the dynamometer and pinch meter (Hammond, pp 257). The Robinson Bashall Functional Assessment, as well as the Stanford Health Assessment Questionnaire, is a functional assessment that allows the therapist to get a better understanding of the practical capabilities of patients that are suffering from RA. The Assessment of Motor and Process Skills allows an accurate estimate of ability to do IADLs based on performance of three tasks.

As per Reitan and Wolfson (1993) raw test scores must be interpreted by adhering to the following method: the WAIS-Information, Comprehension, Similarities and Vocabulary score must be weighed against pre-morbid intellectual competence. Poor scores are more receptive to biological condition and it might indicate brain damage. Next the Halstead Impairment Index is calculated based on the CT, Trail-Making Test B, and Localisation score of the TPT. In case these scores show significant decrease compared to Wechsler result, or the obtained ratio of 0.5 or greater suggests brain damage which resulted in neuropsychological impairment. This is followed by examining the WAIS Verbal versus Performance, bilateral disparity on the FTT and TPT, dysphasia, constructional dyspraxia and deficiency on the Sensory Perceptual Examination which lead to finding the location and orientation of the cerebral damage. Closing step is integrating all the input and interpreting the results concerning the neurological irregularity, predicting the progression of the injury and diagnosing the neurological condition (Reitan & Wolfson, 1993). Various index numbers serve to detect improper brain function. Russsell et al (1970) formulated Average Impairment Rating based on 12 weighted average subtest scores. The General Neuropsychological Deficit Scale (Reitan &

The Lower Extremity Functional Scale (LEFS) is a tool that is administered, and scored due to its’ simple applicability to a vast variety of disability levels and conditions and all lower-extremity sites. This particular scale is easy to read when it comes to understanding error-associated measurements and for verifying the least clinically important score changes and is adequate enough to measure of reliability, validity, and sensitivity to change, at a position that is proportionate with application at an individual patient level (1). The LEFS scale abstract framework is based on the World Health Organization’s model of the handicap and disabled. It was developed to be competent to manage, score, and record in the medical record with

Patients will report to physical therapists with a multitude of impairments throughout the progression of the disease. The most prominent impairments will present during cerebellar testing. Patients will show signs of dysmetria, dysphasia, dysdiadochokinesia, and ataxia primarily as a result of the atrophy and damage to the cerebellum. Instability and lack of postural control will be demonstrated during the Romberg's test. Additionally, cranial nerve testing will have positive results for many cranial nerve palsies such as CN III, V, VII, IX, and XII. Patients show weakness in their trunk and extremities during the manual muscle testing. Vestibular testing will result in abnormal VOR, saccades, smooth pursuits and nystagmus. As a result of these impairments, patients experience functional limitations. Primarily, these patients are considered to be “high fall risks,” which ultimately decreases their independence due to weakness, instability and decreased postural control. These patients will feel uncomfortable in many situations and be unable to function independently in the community. This creates an increased risk for further injury. Due to the dysmetria and weakness, patients will also experience difficulty with their daily living skills, such as maintaining proper hygiene; They will have trouble bathing themselves and brushing their teeth without assistive equipment. PT interventions can help minimize and control these limitations. The implementation of balance training and assistive devices will be imperative interventions for an individual to modify and adapt to their gait

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The advantage of screening instruments compared to neuropsychological batteries is their brevity, easiness to score, capability of giving a broad idea of the patient’s overall cognitive and motor functioning, and help guiding the clinician’s decision to administer a full battery and possibly the necessity of abandoning standard administration and the need for modification. The disadvantages of screening instruments are their limited application of norms to the diverse population of clients, poor specificity and sensitivity, and lack of instruments for motor disorders (Trosten & Brower,

With consent of the individual, they completed a baseline assessment which included the MoCA (Montreal Cognitive Assessment) and the CIHI (Canadian Institute for Health Information) to determine final eligibility. The eligible participants then completed an occupational interview using COPM (Canadian Occupational Performance Measure) with an occupational therapist that was blinded to group allocation for accuracy; this established optimum goals for participation in this study (Clince, 2016). Participants where then videotaped performing the self-selected goals from the COPM. Of the 35 total participants, 26 completed the intervention as well as the post-intervention assessment. In analysis, CO-OP was found to have a medium effect over ability to perform daily activates. The measurable effect of CO-OP over usual care was that it provides evidence to support the result of using CO-OP to improve occupational performance and remediate impairments in arm movement and cognitive flexibility. It also resulted in a positive effect on

Nervous system disorders can be very debilitating diseases. One of those is Multiple Sclerosis. “Multiple sclerosis is a disorder of the CNS that affects 2.5 million people worldwide, and 400,000 in North America.”(Holes Human Anatomy and Physiology 13th edition, pg. 366) The CNS or the central nervous system is made up of the brain and spinal cord. “In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause the nerves themselves to deteriorate or become permanently damaged.” (mayoclinic.org, by mayo clinic staff, Oct. 1, 2015) Knowing the symptoms of MS for early diagnoses is crucial when treating this disease.

Reliability: Good internal consistency as demonstrated by Cronbach’s alpha=0.90 for DASH disability and symptom scale

syndrome: A critical review. Quality Of Life Research: An International Journal of Quality Of Life Aspects of Treatment, Care & Rehabilitation, 23(9), 2407-2416.

Since the patient does not possess isolated movement in his hemiplegic arm and has some ability to grasp and extend his fingers, this is an appropriate outcome measure to use with this patient to evaluate and quantify the performance as well as the severity of motor function of his involved upper extremity. The current modified 17-item scale has been adjusted for ease of performance for individuals who may have minimal movement in the hemiplegic limb.

2-6: A recent study done by Malak et al. (2015), aimed to “examine the gross motor function and estimate what motor abilities are significantly delayed in children with DS even with physical therapy…and to assess their functional balance”. The subjects of the study were 79 children with DS ranging in age from 0-6. The children were then further divided into 3 groups based on age and motor impairment- mild, medium or severe. All the children

TST boosting, of both a subsequent TST and a subsequent QFT-GIT, was demonstrated. For the assessment of TST boosting on a subsequent TST (Assessment III), of those with a negative initial TST, 38% (left arm TST) and 40% (right arm TST) converted to a positive TST when the TST was administered a week later. These boosting rates are higher than the range of rates seen in the literature (5.1% to 13.2%). One likely reason for this is that all of the subjects in this study had a prior positive TST, which was not the case in any of the populations used in the previous studies. For the assessment of TST boosting on a subsequent QFT-GIT (Assessment IV), of those with a negative initial QFT-GIT, 34% converted to a positive QFT-GIT when the

20 [right-handed] healthy adults (7 females; mean age of 23.6 years; 19-34 years range) participated in the study after giving written informed consent as approved by [University, Program]. Each participant had normal or corrected to normal vision and normal hearing. None of the subjects had current or prior neurological or psychiatric illnesses.