Interventions for Activities of Daily Living

Interventions for Activities of Daily Living

• Rehabilitation programs aim to restore independence in daily living.
• Activities of daily living (ADL) are tasks essential for self-care, including feeding, dressing, hygiene, and mobility.
• ADLs can be extremely challenging for individuals with cognitive, motor, or sensory impairments.
• Family support is crucial for successful rehabilitation outcomes.
• A stable and supportive family unit assists the rehabilitation process.
• Lack of family involvement negatively impacts rehabilitation outcomes.
• Excessive family support can foster dependence in the patient.
• Involving the family in all aspects of rehabilitation (evaluation, goals, and treatment) is beneficial before and after discharge.

Management of Self-Care Tasks: Assessment

• Functional assessment describes abilities and limitations, measuring the use of daily living skills.
• It includes leisure activities, vocational needs, social interactions, and other essential behaviors.

Evaluations of ADL

• Evaluations consider the value of the activity to the client.
• Level of independence in performing tasks (initiation, continuation, completion).
• Safety during the activity.
• Adequacy of task performance, factoring in difficulty, pain, fatigue, dyspnea, efficiency, social standards, satisfaction, and experience.
• Crucial parameters for comprehensive evaluation in assessments.

Several Considerations During Assessment

• The chosen setting must support the specific evaluation type and be free of distractions.
• The environment should replicate the patient's usual environment for accurate assessments.

Principles of Functional Assessment of ADL

• Functional assessment analyzes and classifies functional activities.
• It determines an individual's ability to engage in them.
• It measures how a person performs tasks and fulfils roles in life.

Types of Assessment

• Performance-based assessment:
  • A therapist observes the patient performing the activity.
• Self-assessment:
  • A survey or questionnaire answered directly by the patient.

Instructions and Assessments

• Instructions should be precise.
• Assessments may be biased by fatigue (especially if best in the morning but tires in the afternoon).
• Consider variations in performance.
• Inform the patient that the testing may take multiple sessions.

Physical Therapy Interventions for ADLs

• Compensatory:
  • Alter the task (e.g., using two hands).
  • Adapt the task (e.g., using assistive devices).
  • Modify the environment (e.g., adapting the environment).
• Restorative:
  • Focuses on restoring capacities (e.g., strength, endurance, ROM exercises).
• Education:
  • Methods match the client's needs.
  • Group instruction efficient for homogenous populations.
  • Video use is efficient in the comfort of the patient's home
  • Individual training best for specific tasks.

Factors Influencing Performance Outcome

• Client's ability to learn.
• Client's prognosis.
• Time allocated for intervention.
• Client's discharge disposition.
• Ability of the client to follow new techniques.

Physical Therapy Intervention: Hygiene

• Compensatory strategies for hygiene:
  • Adapt equipment to support holding, controlling, and reaching.
  • Organize items on a counter or shelf using baskets and plastic containers easily transportable.

Restoration

• Restoration techniques (ROM, splinting, prosthetic training, motor learning, inhibitory and facilitation treatment, sensory reeducation).

Education

• Demonstrate proper adapted task usage.
• Handouts with pictures/drawings.
• Video examples of strategies.