maximizing function-goal setting and the rehab perspective deborah gaebler-spira, md rehabilitation...

Maximizing Function-Goal Setting and the Rehab

Perspective

Deborah Gaebler-Spira, MDRehabilitation Institute of Chicago

Partnering for Progress: A Cerebral Palsy Conference for Parents & CaregiversAugust 11,2007, Chicago, Illinois

Goals of Rehabilitation

Prevent secondary complications-deformity Improve and support function/development Promote assets-kids are not a sum of the

deficits

Rehabilitation domains

Self Care-dressing, bathing, toileting Communication Mobility-ambulation, transfers, stairs Continence-bowel and bladder

Developmental perspective

Gross motor Fine motor Personal social language

Developmental Assements

Vineland Peabody Batelle Bailey

Goals change as the child grows

Parent driven Therapist driven Doctor driven! Educationally driven

Mobility just gets you from here to there

National Center for Rehabilitation research model

Pathophysiology Impairment Disability Functional limitation Societal limitation

Adopted as outcome paradigm

Old WHO

Impairment Disability handicap

WHO 2001 model-International classification of function/components of health

Impairment Activities Participation Impact of environment and personal factors

New/WHO/ICF

Body structure and function

Physiologic functions of the body

Anatomical parts of the body

Impairments

Problems in body functions or structure, loss or deviations

Activities

Execution of a task or action by an individual

Participation

Involvement of a life situation

ICF

Functioning and disability -body functions and

structures Activities and

participation

Contextual factors Environmental personal

Environmental factors

External factors Facilitating or hindering

impact of the physical, social and attitudinal world

Personal factors

Internal influences Or attributes of the

individual

Maximizing function

Therapy to Augment Function Compensate for Function Technology to assist function