ICRC Physiotherapy Standards Rehab Cycle

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Welcome to The ICRC Physiotherapy Standards Content Development Project. This space was created by Physiopedia for the creation of content relating to the ICRC Physiotherapy Standards Workshop. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

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Top Contributors - Kim Jackson

Related Pages[edit | edit source]

Professional Standards in (ICRC) Physiotherapy
ICRC Physiotherapy Standards Project Cycle
ICRC Physiotherapy Standards Rehab Cycle

Introduction[edit | edit source]

A number of PT standards are related to the rehab cycle of an individual patient or service user. It is advised to apply the ICF-Model for rehab cycle and for any intervention with a rehabilitation user. Click HERE for more information and for an e-learning module on ICF visit this LINK.

See the tools and documents accompanying different steps of the rehab cycle.

Assess and Analyse[edit | edit source]

The assessment process is an important step in the rehab cycle. Information collected during an assessment can guide clinical reasoning and, by evaluating a person's individual needs, enhance the the rehabilitation experience as well as identifying gaps in service provision that can aid the improvement of physiotherapy services.

Assessment can be considered to be the first step in the rehabilitation process. It is a continuous process, where information is gathered through various sources. The information once gathered is interpreted and the main aim is to identify key problems and then formulate a treatment plan which is relevant to the individual.

It is important to perform a good quality assessment, as the quality of care given is based on the assessment. This assessment should identify any additional factors that may contribute to the service users/patients presenting problems. The assessment process will assist the physiotherapist to recognize his/her own expertise and limitations, and where necessary refer to other disciplines as indicated.

The key elements of the assessment process require the gathering information from relevant sources, medical notes, investigations. Important sources that are required to develop a deep understanding of the person and situation include:

Demographics - After taking the demographic information (which could also be retrieved by the general file), it is important to ask for the service user/patient informed consent. Oral consent should be received by every service user/patient prior to assessment/treatment and can be written in certain contexts.
Assessment - It is not always feasible to gather information required at one time, assessments may be ongoing, depending on the complexity of the problem. The purpose is to establish the service user/patient’s physical, psychological and social needs and perceptions of their needs through the interview. It is also desirable to get an insight into the person’s expectations of their assessment and subsequent treatment.

It is important to keep a clear, structured format of the assessment, for example using the SOAP note format. SOAP is an acronym for:

Subjective - What the patient says about the problem / intervention.
Objective - The therapists objective observations and treatment interventions (e.g. ROM, Outcome Measures)
Analysis - The therapists analysis of the various components of the assessment.
Plan - How the treatment will be developed to the reach the goals or objectives.

Subjective Assessment[edit | edit source]

Assessment and Treatment Guidance [Word doc]

Outcome Measures[edit | edit source]

Outcomes measures for an individual user must be chosen according to their health condition and rehabilitation goals. There are generic outcome measures that should be performed with each user. When measuring health and disability we advise using the Manual for WHO Disability Assessment Schedule (WHODAS 2.0) for this purpose.

For more consistency we also advise a few simple outcomes measures for the following health conditions and clinical pictures :

Lower limb conditions (due to amputation, fracture, stroke, incomplete SCI, Polio, old age, etc.)

- Single Leg Stance Criteria
- TUG L and Time walk test

Upper limb conditions (due to amputation, fracture, stroke etc.)

- Action Research Arm Test (ARAT) - (ICRC (ARAT) Link)
- Watch the video : ARAT Test

Any condition
- Patient Specific Functional Scale
- Goal attainment scaling (GAS) in rehabilitation - a practical guide.pdf
Functionality
- WHO Disability Assessment Schedule (WHODAS)
  - WHODAS 12item scoring template [Excel Doc]
  - WHODAS 36item scoring template [Excel Doc]

Note - You are encouraged to individually select and use additional outcome measures for and with each user. Remember: measuring outcome is not a goal in itself (it's the outcome that counts, not the measuring) – keep it short and simple!