ONCOLOGY 2024
ELLAIZA ASTACAAN
WEAKNESS
STAPLES MMT
COPM + MS contraction
• Self-care, leisure, productivity + amount of ROM through which the joint passes when the muscle contracts+
• Rate 1-10 importance + amount of resistance against which the muscle can contract
FIM
• 7-point Likert scale steps:
• ADL • position
• interview • stabilize: proximal
No Helper • palpate: avoid using the thumb (has on pulse)
• 7. Complete • observe: substitutions/diff.; test motion then back to original position
Independence (Timely, • resist
Safety) • grade
• 6. Modified
Independence (Device)
Helper - Modified
Dependence
• 5. Supervision (Subject
= 100%)
• 4. Minimal Assistance
(Subject = 75% or
more)
• 3. Moderate Assistance
(Subject = 50% or
more)
Helper - Complete
Dependence
• 2. Maximal Assistance
(Subject = 25% or
more)
• 1. Total Assistance or
not Testable (Subject
less than 25%)
INTEREST CHECKLIST
• Level of Interest (strong, some, no)
o Past 10 years
o Past year
• Do you currently Participate (yes/no)
• Would you like to Participate (yes/no)
CONTRACTURES
ROM GAIT AND BALANCE
BERG BALANCE SCALE
• 0 lowest, 4 high
functionalities
• 14 steps
Scoring and Interpretation:
56 = functional balance
< 45 greater risk of fall
≤ 49 risk of falls of individuals with
stroke
TINNETI BALANCE SCALE
FATIGUE AND ENDURANCE PAIN
BORG SCALE – DYSPNEA SCALE PAIN ASSESSMENT SCALE
6 MINUTE WALK TEST
EDEMA
• distance covered over a time of 6 minutes
PITTING AND NON-PITTING EDEMA
• 30-metre stretch of unimpeded walkway
• Pitting Edema – indentation persists, a.k.a cutaneous edema
• Pulse oximeter for measuring heart rate and SpO2 (optional)
• Non-Pitting Edema – edema does not persist
Borg Breathlessness Scale (optional)
FATIGUE SEVERITY SCALE
• Low = 1 (disagree)
• High= 7 (agree)
Less than 30 TS = not suffering
from fatigue
36 and above =
fatigue
EDEMA AND MUSCLE BULK OR GIRTH
VOLUMETER
• Measure unaffected side first
• Ankle = standing or sitting
• Hand = participant’s hand is placed slowly into the volumeter with forearm
pronated, fingers adducted, and thumb facing the spout until the web of the
middle and ring finger rested on the stop dowel of the volumeter
>10 ML
TAPE MEASURE CIRCUMFERENTIAL MEASUREMENT DEEP TENDON REFLEX
• Wrap around area
The circumferential method is one of the girth measurement techniques. For consistent
measurements, each upper extremity or lower extremity is marked with a semi-permanent
marker at a certain part with reference to the bony prominences
TAPE MEASURE FIGURE OF 8 MEASUREMENT
• Start with unaffected side
• 2cm difference = edema
Hand Foot
• Distal end of the ulnar styloid • Start at tibialis anterior tendon
process • Inside of the foot or navicular
• Back of hand to the radial styloid tuberosity
process • Base of fifth metatarsal bone
• Across the palm, diagonally • Cross it over to the inner side of
towards the 5th metacarpal head the ankle or medial malleolus
• Wrap around the base of the • Cross over just under the lateral
thumb, bring across the palm, over malleolus
the distal palmar crease • Return to starting point
• Return to starting point
MUSCLE TONE
MUSCLE TONE GRADE
ADL
BARTHEL INDEX WHEEL CHAIR CONSIDERATIONS
Overview: Scoring and Interpretation: WHEEL CHAIR ASSESSMENT
1. Feeding 0 = needs help, dependent
2. Bathing 5 = modified
3. Grooming 10 = independent
4. Dressing
5. Bowel • 0-20 indicate “total” dependency
6. Bladder • 21-60 indicate “severe”
7. Toilet use dependency
8. Transfers bed-to-chair-and-back • 61-90 indicate “moderate”
9. Mobility on level surfaces dependency
10. Stair negotiation • 91-99 indicate “slight” dependency
LAWTON BRODY IADL
• using the telephone Women
• shopping • 0 (low function, dependent)
• preparing meals • 8 (high function, independent)
• housekeeping Men
• using transportation • 0 (low function, dependent)
• taking medication(s) • 5 (high function, independent)
• managing finances
KOHLMAN EVALUATIONOF LIVING SKILLS (KELS) Considerations:
• Self-care 17 items • propelling the wheelchair
• Safety and Health 0 = independent • frame style
• Money Management 1 = needs assistance • type: manual/electric, recline/tilt, folding/rigid, standard/lightweight, standard/custom
• Transportation and Telephone
• Work and Leisure 6 to 17 indicates need for assistance
5.5 or less indicates a client is capable of
living independently
MILUAUKEE EVALUATION OF DAILY LIVING SKILLS
• I – Independent
• E – evaluation needed in this
skill area
• NA – not applicable to the client
PRESSURE ULCERS A. pivot
BRADEN SCALE • stand
(at risk) • stand/step
Domains: 1 (low), 4 (high) • bent
• sensory perception SEVERE RISK: 9 B. sliding board
• moisture HIGH RISK: 10-12 C. dependent
• activity MODERATE RISK: 13-14 • 1-person
• mobility MILD RISK: 15-18 • 2-person
• nutrition D. mechanical
• friction and shear
PUSH
(+) pressure ulcer
PRESSURE ULCERS
QOL
WHOQOL-BREF
1 – not at all 45 Low QOL
2 – not much 46-65 Moderate
3 - moderate 65 High QOL
4 – a great deal
5 - completely
HOME OR ENVIRONMENTLA ASSESSMENT
COUGAR
Environment Safe SAFETY SCORE: Percent Safe = {# Safe}÷
Environment Unsafe {74 minus # Not rated}
INTERVENTIONS
ECT
• 4Ps
• Work Simplification Techniques, sleep
• Orthotics
• AD
TRANSFERS
ENDOCRINOLOGY
ELLAIZA ASTACAAN
POSSIBLE ASSESSMENT TOOLS
PAIN ASSESSMENT TOOL
PQRST
SENSORY ASSESSMENT
ASSESSMENT TOOLS OTHER MEASUREMENTS
OPHI – OCCUPATIONAL HISTORY INTERVIEW HR
• Area of Assessment 4 = exceptionally competent occupational
• Activities of Daily Living functioning
• Behavior 3 = good, appropriate, satisfactory
• Life Participation occupational functioning
• Occupational Performance 2 = some occupational functioning
• Mental Health problems
• Quality of Life 1 = extreme occupational functioning
• Social Relationships problems
• Social Support
BECKS DEPRESSION INVENTORY BODY MASS INDEX
BMI = kg/m2
• 21 items 0
WAIST CIRCUMFERENCE
0–9: indicates minimal depression 1
• Top of hip bone, and below last rib
10–18: indicates mild depression 2
19–29: indicates moderate depression 3 severe
30–63: indicates severe depression.
PSYCHOSOCIAL ASSESSMENT TOOL
• Triage Family History Sample Questions
INTERVENTIONS
• Relationships • Who was client’s primary caregiver?
• Abuse History • Was there ever a time when client’s POSSIBLE INTERVENTIONS
• Spiritual & Cultural Issues primary caregiver(s) was 1. Lifestyle Modification
• Educational Status & History • Client’s sexual orientation o Diet – OTs monitor in collaboration with dietitian
• Financial at Entry (Heterosexual/Homosexual/Bisexual o Routine Modification (stretching→ strengthening→ aerobic)
• Employment Status & History /NA) Does client have any concerns o Self-monitoring – vital signs, eating habits, medicines
• Living Arrangements about his/her sexual practices? 2. Behavior Therapy
• Activities Information (yes/no o Eating habits
• Legal Status & History o Stress management
o Social support
3. Exercise Eval and Prescription
MEASUREMENTS
o 2-3 mets– inc 0.5-1.0 (walking, water aerobics, yoga, stationary bikes)
SKINFOLD CALIPER
o Precautions
Used to assess the skinfold thickness, so that a prediction of the total amount of body fat
can be made.
SENSORY RE-EDUCATION AND OTHERS
Men Women
Chest triceps
Abdomen suprailiac
thigh thigh
UPPER AND
LOWER
EXTREMITIES
ELLAIZA ASTACAAN
RANGE OF MOTION AND STRENGTH • Squeeze three times, 1 min in
ROM between
Two Ways:
• Assess individual muscles
• Assess muscle groups
MMT
Jebsen Hand Dynamometer
• Client is seated Normal Values depend on age
• Arms adducted and forearm in
neutral
• Elbow at 90 degrees flexion
• Wrist 0-30 degrees extension
• Hand in 15 degrees ulnar deviation
