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FAQs for Case managers - Functional rehabilitation

What is a functional assessment?

A functional assessment involves gathering information on a person’s condition and observing them completing everyday activities including mobility, transfers, preparing food and attending to personal hygiene. An analysis of the client completing such activities will include the examination of their orientation, planning, sequencing, safety awareness, motor control, coordination and balance.

What is activity analyses?

Activity analysis is the principle element of a functional assessment and is a core skill of the occupational therapist. It involves pulling apart the various competencies required in order to complete an activity and considers the demand of each aspect on the participant.

What is a SMART goal?

SMART is an acronym used to define the contents of goal setting. Each goal set with a client should be; Specific, Measurable, Achievable, Realistic and Time specific. An example of a SMART goal is; “to be able to consecutively ascend and descend a full flight of stairs, using newly fitted bilateral hand rails within two weeks.” This specifies exactly what needs to be achieved, the time frame it needs to be achieved in and how to measure this (ascend and descend consecutively). Depending on the person’s current and previous level of ability to complete stairs will inform the therapist whether the goal is realistic. Ensuring that a goal is achievable may depend on the availability of the equipment required, in this case the fitting of the stair rails.

What is meant by the terms compensatory and restorative approaches?

A compensatory approach to rehabilitation involves teaching strategies and techniques or providing equipment and aids in order to compensate for a dysfunction. A restorative approach promotes the return of lost functions via participation in functional tasks and exercises. Any treatment approaches used should be focused on the goals set by the client and will reflect what is important to them.

What are the common outcomes of functional rehabilitation?

During a functional assessment, certain areas of difficulty may be highlighted. Common areas of difficulty are; standing up from a chair/bed/sofa, lifting legs into bed, moving from a lying position to sitting up in bed, accessing a bath or shower, managing stairs and steps and completing personal hygiene and domestic tasks. The OT will discuss these concerns with the client and find out what they would like to be able to achieve. They will use SMART goals in order to guide intervention and ensure that treatment is appropriate and meaningful for the client. OTs are likely to use compensatory and restorative approaches in conjunction (where appropriate) in order to rectify the types of issues described above. They may recommend physiotherapy input to promote muscle restoration and provide equipment to ease transfers. For example, a toilet frame and chair raisers to assist sit to stand or additional hand rails to provide support when accessing baths/showers/stairs. They may recommend that activities such as washing and dressing or preparing a meal are graded into smaller chunks and gradually built upon in order to restore function.

Who will benefit from functional rehabilitation?

Any client who is having difficulty with everyday tasks will benefit from an occupational therapy assessment in order to determine the extent of their difficulties and the need for further rehabilitation. The benefits of undergoing functional rehabilitation are attributed to the reestablishment of participation in meaningful activities and the impact this has on a person’s mental well-being, self-esteem and self-identity and this should always be considered. If you would like to talk a case through or have any queries about a potential referral then please do not hesitate to contact The OT Practice on 0330 024 9910 or by emailing [](mailto:

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