Assessing Disability
- 1. ASSESSING FUNCTIONAL DISABILITY AMC linear disability score DASH score Glasgow Outcome Score Rankin Disability Score Pain scales
- 2. Applications Measuring self-rated health change after surgery (Gummesson, Atroshi and Ekdahl1; BMC Musculoskeletal Disorders 2003, 4:11) Quantifying functional status
- 3. Introduction “Functional status is now seen as an important determinant of patients' quality of life and a wide variety of instruments have been developed” (Lindeboom R, Vermeulen M, Holman R, de Haan RJ: Activities of daily living instruments in clinical neurology. optimizing scales for neurologic assessments Neurology 2003, 60:738-742) Life satisfaction, not number of symptoms is the strongest predictor of perceived poor health. (http://www.hqlo.com/content/3/1/28) http://www.hqlo.com/content/3/1/28)
- 5. Glasgow Outcome Score GOS=1 (Good Recovery) Capacity to resume normal occupational and social activites, although there may be minor physical or mental deficits or symptoms. GOS=2 (Moderate Disability) Independent and can resume almost all activites of daily living. Disabled to the extent that they can not participate in a variety of social and work activites.
- 6. GOS cont’d… GOS=3 (Severe Disability) No longer capable of engaging in most previous personal, social or work activities. Limited communication skills and have abnormal behavioural or emotional responses. Typically are partially or totally dependent on assistance from others in daily living. GOS=4 (Persistent Vegetative State) Not aware of surroundings or purposely responsive to stimuli. GOS=5 (Dead)
- 7. Rankin Disability Score Rankin=0 No symptoms at all Rankin=1 No significant disability despite symptoms; able to carry out all usual duties and activities. Rankin=2 Slight disability. Unable to carry out all normal activities but able to look after own affairs without assistance. Rankin=3 Moderate disability requiring some help but able to walk without assistance.
- 8. RDS cont’d… Rankin=4 Moderately severe disability. Unable to walk without assistance, and unable to attend to own bodily needs without assistance. Rankin=5 Severe disability. Bedridden, incontinent and requiring constant nursing care and attention.
- 9. AMC linear disability score 79 items (activities) scored as Not applicable Can do Cannot do Algorithm can be used as a foundation for quantifying functional status (Health Qual Life Outcomes. 2005 Dec 29;3:83) http://www.hqlo.com/content/2/1/42
- 11. DASH SCORE Score 0 (no deficit) – 100 (severe disability) The DASH can detect and differentiate small and large changes of disability over time after surgery in patients with upper- extremity musculoskeletal disorders. A 10-point difference in mean DASH score may be considered as a minimal important change.
- 12. CASE STUDY Split into 5 groups Read through the case study to OH advice section Carry out DASH assessment and agree scores within the group Read through OH advice section Repeat DASH score using a different pen