assessment Parwin Yari MD ( Rehabilation specialist) Anne Carien - - PowerPoint PPT Presentation

The 2nd European Polio Conference Amsterdam // 25-27 June 2014

Multidisciplinary one day rehabilitation assessment

Parwin Yari MD ( Rehabilation specialist) Anne Carien Beishuizen ( Physiotherapist) Dorien Toor ( Occupational therapist) Liesbeth Eggink ( Medical social worker)

Content

1 How is the Multidisciplinary one-day Rehabilitation assessment achieved? P.Yari 2 Who is eligible to participate? P.Yari 3 How is the day organized? A.C Beishuizen, D. Toor, L. Eggink , P.Yari

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Content

1 How is the Multidisciplinary one-day Rehabilitation assessment achieved? P.Yari 2 Who is eligible to participate? P.Yari 3 How is the day organized? A.C Beishuizen, D. Toor, L. Eggink , P.Yari

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• Post polio expertise centre
• 15,000 people in the Netherlands are registered as having poliomyelitis
• Immigrants and foreign nationals with polio
• In AMC 1/3 of all polio patients are foreign
• Younger, more complex patients

1- How is the Multidisciplinary one-day assessment achieved?

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Initially, only diagnosis was performed In 2007 the first One-day assessment was organized

1- How is the Multidisciplinary one-day assessment achieved?

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Content

1 How is the Multidisciplinary one-day Rehabilitation assessment achieved? P.Yari 2 Who is eligible to participate? P.Yari 3 How is the day organized? A.C Beishuizen, D. Toor, L. Eggink , P.Yari

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• Referral letter
• Rehabilitation specialist
• Interview and physical examination
• Additional tests
• muscle MRI
• x-ray
• or gait analysis

2- Who is eligible to participate?

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2- Who is eligible to participate?

• Criteria for participation
• Goal of the session

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Criteria for participation:

• multiproblems
• questions about managing symptoms

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2- Who is eligible to participate?

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Goal of the session

• give insight into which factors lead to problems

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2- Who is eligible to participate?

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Content

1 How is the Multidisciplinary one-day Rehabilitation assessment achieved? P.Yari 2 Who is eligible to participate? P.Yari 3 How is the day organized? P.Yari , A.C Beishuizen, D. Toor, L. Eggink

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Two patients a month Questionnaire

3- How is the day organized?

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The most attention is paid to the main problem! Topic issues:

• Reduction of pain, tiredness and overload
• Improving fitness, exercise and sport
• Advice on home and work adjustments
• Advice on the use of walking aids
• Social and emotional items
• how to deal with physical complaints, with acceptance, with fear of being

dependent and with concerns about the future

3- How is the day organized?

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Physiotherapist Occupational therapist Medical social worker Rehabilitation physican

3- How is the day organized?

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Expert advice … that moves boundaries

snapshots on my timeline

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• Preparations
• Case history
• patients needs!
• Examination
• Report and proposal for improvements

Physiotherapist

Preparation:

Physiotherapist

Medical history General information MRI muscles Muscle condition X-ray Joint problems Gait analysis Walking problems Questionnaire Patient’s needs Polio Problem List Patient’s main problems CISS questionnaire Coping strategies Daily activity list Daily activities

Case History:

• Exploration of the patient’s needs
• The three main problems of the Polio Problem List

Physiotherapist

Examination:

• 2 minute Walking Test
• Submaximal Cycle Test
• Joint Mobility
• Observing Problem Activities and Transfers
• Borg Scale/Rating of Perceived Exertion
• 6 minute Walking Test
• Observing Effects of Walking Aids

Physiotherapist

Report and proposal for improvement:

• Outcomes of diagnostic tests
• Recommendations for therapy

Physiotherapist

Physiotherapist

Goals of the intervention:

• Understanding the problems, origins and consequences
• Finding a proper balance between physical capacities

and physical activities

Occupational Therapist

• Preparations
• Case history
• patients needs!
• Examination
• Report and proposal for improvements

Preparations:

Occupational Therapist

Medical history General information MRI muscles Muscle condition X-ray Joint problems Gait analysis Walking problems Questionnaire Patient’s needs Polio Problem List Patient’s main problems CISS questionnaire Coping strategies Daily activity list Daily activities

Case history:

• semi-structured interview: COPM

(Canadian Occupational Perfomance Measure)

• exploration of the physical and social environment

Problems with daily living and work skills? Activities which lead to overload, pain, tiredness and/or unsafety situations?

Occupational Therapist

Examination:

• Daily Activity List
• Observations

Occupational Therapist

Report and proposal for improvement:

• Findings and conclusions
• Recommendations for therapy

Common goals for further therapy:

• adjust heavy daily activities
• advices for aids
• improving sitting positions

Occupational Therapist

Medical Social Worker

• Preparations
• Case history
• patients needs!
• Examination
• Report and proposal for improvements

Preparations:

Medical Social Worker

Medical history General information MRI muscles Muscle condition X-ray Joint problems Gait analysis Walking problems Questionnaire Patient’s needs Polio Problem List Patient’s main problems CISS questionnaire Coping strategies Daily activity list Daily activities

The Goal :

• To assess the social functioning of the patient.
• To advice on the treatment and assistance.

Medical Social Worker

Case History:

• Exploration of the patient’s needs
• The three main problems of the Polio Problem List
• Balance in social functioning

Medical Social Worker

• Task-oriented coping
• Emotion-oriented coping
• Avoidance-oriented coping

Examination

Focus during the consult:

• the aid request
• the findings, by using

the CISS questionnaire (Coping Inventory for Stress Situations)

and HADS questionnaire (Hospital Anxiety and Depressions Scale)

Medical Social Worker

Advise:

• Patient can cope the problem
• Contact social medical worker/psychologist

Medical Social Worker

Conclusion Most common request for aid :

• Finding a balance in life.
• The struggle in dealing with the limitations, that the

patient has experienced for years.

Medical Social Worker

Rehabilitation Physican

Preparation:

Medical history General information MRI muscles Muscle condition X-ray Joint problems Gait analysis Walking problems Questionnaire Patient’s needs Polio Problem List Patient’s main problems CISS questionnaire Coping strategies Daily activity list Daily activities 34

• Team meeting without patient for 15 minutes
• Team meeting with patient for 30 minutes
• Further treatment necessary?

3- How is the day organized?

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Orthosis

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3- How is the day organized?

 A full report is sent within 2 weeks  Telephone evaluation 37

Disclosure sheet

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Disclosure of speaker’s interest

(Potential) conflict of interest None Potentially relevant company relationships in connection with event

• Sponsorship of research funding
• Fee or other (financial payment)
• Shareholder
• Other relationships, i.e.

Thank you for your attention!

Questions?

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