Occupational Therapy Assessment of Functional Problems in the Rehabilitation of the Severely Head Injured

Abstract

The multiple and complex problems of the head injured patient require comprehensive and systematic evaluation. While physical and psychological assessments are well established, there is a notable absence of adequately standardised assessments of functional ability for clinical application by occupational therapists. Accordingly, a battery of tests has been devised covering four major areas of functional ability: visual perception; constructional ability; sensorimotor function; and execution of complex instructions. A comparison of the performance of 40 head injured patients with 40 controls is described. Significant group differences were evident for overall performance (representing ability and time factors) on all 12 tests of the battery with the head injured group exhibiting a wide range of problems. The implications of these results and the role of the assessment battery in diagnosis, treatment, and evaluation are discussed.

Assessment Tools Used by Occupational Therapists with Head Injured Patients in a Rehabilitation Setting

“…Measurement scales designed for multidisciplinary use have also been developed to determine level of function, and these are being increasingly used to demonstrate the functional gain shown by patients throughout the rehabilitation process (Mahoney and Barthel, 1965;Hamilton et ai, 1987;Johnston et ai, 1992;Rappaport et aI, 1992;Powell et ai, 1994;Schut and Stam, 1994). Specifically within occupational therapy, in an attempt to become more scientific in approach, standardised assessments are now available, but these tend to focus on the identification of the component skill deficit (Hadfield and Tyerman, 1983;Whiting et ai, 1985;Wilson et ai, 1985;Tyerman et ai, 1986). Some work has already been done in comparing different standardised assessment batteries (Bradley et ai, 1982;Sloan, 1991).…”