Physical, Functional & Cognitive Assesment
Pain assessments and management
Occupational Therapists are experts at assessing activities of your daily life, setting goals and assisting with adaptations and recommendations to assist you with reaching those goals despite a medical condition/diagnosis.
As Occupational Therapists we specialise in a holistic approach when assisting and treating clients. People with pain often feel hopeless or that people do not believe them, or that they are exaggerating. We understand that pain is a unique experience for each individual and the difficulties that pain may cause in your life. Our aim is to give you your control back and assist you with returning to your activity participation, such as your hobbies, self-care, taking care of your home, your children and returning to work.
We have attended the following training provided by Train Pain™ Practitioners to ensure we are equipped to assist you in the correct manner:
- Assessment and Mechanisms of Pain
- Treatment of Pain
- Return to work for Pain and Fatigue.
Which pain conditions can we assist you with:
- Phantom Limb Pain
- Chronic Regional Pain Syndrome
- Fibromyalgia
- Back pain
- Neck pain
- General body pain
- Upper and lower limb pain
- An operation/surgical procedure
- Hypersensitivity after amputation
What can be expected during our sessions:
- During our first session we shall conduct an interview to ensure we have a comprehensive understanding of how you are experiencing your pain and what limitations and difficulties you might be having because of the pain.
- We shall use standardized tests to assess your pain and its intensity and facilitate your journey to returning to activity participation.
- We (Client and Occupational Therapist) work as a team to set goal for our therapy sessions.
- Education of what pain is and how the body’s’ understanding and processing of pain.
- Education of specialised pain management techniques.
- As pain in multi-dimensional, we work in a multi-disciplinary team – members may include a Psychologist, Medical Doctors which specialise in pain, Biokineticists, Physiotherapist or a dietician)
- We will provide you with the relevant referrals to other team members if needed to assist us on your pain management journey.
- We work at a pace which is comfortable for you .
‘This is your journey, we are here to facilitate it at a speed which is comfortable for you, lets tackle your pain together.’ (Melissa Vaughan, Occupational Therapist.)
HCAT (Cognitive assessments)
The H-CAT is a South-African developed cognitive instrument, testing general cognitive ability as a component of Executive Functioning.
General Cognitive Ability as part of Executive Functions
Executive functions include a “family of cognitive processes” that has to do with managing oneself and resources in order to perform work (1). Poor Executive functions could evidently be responsible for poor productivity at work and difficulty with finding and keeping a job (2). The levels of Executive Functioning as described by Diamond (2012) include inhibition, working memory, cognitive flexibility; and then from these, higher level executive functions are built (1). These higher-level executive functions include planning, reasoning and problem solving (general cognitive ability). General cognitive ability, refers to the ability to learn, understand instructions, processing information, reasoning, problem-solving and handling of mental demands (3;4). The degree of general cognitive ability has also been found to be a strong predictor of job performance and job training, regardless of the type of work (4;5;6). The H-CAT is a South-African developed cognitive instrument, testing general cognitive ability as a component of Executive Functioning.
Skill and abilities measured with the H-CAT include:
- Ability to define and reason around problems during problem-solving
- Ability to analyse a problem from various angles to establish the best possible solution
- Elimination techniques in order to solve problems
- Verbal reasoning in the client’s preferred language
- Ability to reason around abstract concepts during problem-solving
- Ability to learn from previous formed thought patterns
Testing is performed online in a proctored environment.
Rehabilitation and Functional Assessment (RFA) test battery in conjunction with The Work Expert
‘The RFA test is a standardized test designed to assess the individual’s inherent capacity (cardiorespiratory fitness) and functional capacity to perform and endure manual work in a safe and productive manner over an 8-hour shift. It assesses mobility in both restricted and unrestricted environments, different work positions, effort ability needed in restricted and unrestricted work environments and dexterity in different work positions.
In conjunction with medical assessment, the RFA test provides the physical and functional work capacity assessments during the medical screening process.
“The RFA test battery assists in Determining the health profile of your employees whilst assessing work capacity”
- Assess prospective employees to ensure a proper match between worker capabilities and inherent job requirements
- Assess in-service employees post injury / illness to allow for safe return to work
- Facilitate early return to work by means of monitoring the rehabilitation process from the onset until return to work
- Facilitate alternative employment based on a comprehensive work capacity profile, highlighting residual abilities, and indicating possible limitations
- Assessment as part of periodical medical assessments – to promote a healthy lifestyle and implement proactive health promotion programs. Reference: The Work Expert (https://www.rfac.co.za/)
FCE (Functional Capacity Evaluations)
Functional Capacity Evaluation (FCE)
‘A functional capacity evaluation (FCE) evaluates an individual’s capacity to perform work activities related to his or her participation in employment.’ (Soer et al., 2008). The FCE process compares the individual’s health status, cognitive ability, physical ability and body functions and the demands of the occupation and the work environment. A FCE’s primary purpose is to evaluate a person’s ability to participate in work . Although as Occupational Therapists, we also assess the activities of daily living such as home preparation, grooming, gardening, recreational activities, all the activities which are important to you as a person.
Who Can Benefit From an FCE?
- Someone who has been injured on duty to determine his or her ability to return to his/her occupation with or without accommodation or alternative occupation.
- Someone applying for Disability benefits or incapacity benefits.
- Someone seeking to return to work after an injury or illness.
- Someone
The FCE may be used to determine:
- Goals for cognitive and/or physical rehabilitation
- The clients ability to safely return to work (including full duty, duties with accomdations, gradual return to work or redeployment to another occupation)
- Work ability status for vocational rehabilitation
- Disability status
- Ability to meet job demands as part of a hiring process (pre-work/post-offer employment testing)
- Ability to meet the demands of other activities (Home tasks, gardening, social acitivites)
What can be expected on the day of your FCE:
An FCE assessment includes an interview to ensure who receive a holistic picture of the injury/illness and difficulties you are currently experiencing. The assessment may take 3 -4 hours as it includes functional testing relating to your injury/illness/diagnosis. The testing may include cognitive assessment, lifting, walking, stepping, balancing, pain monitoring as well as and hand function.
A comprehensive report is compiled after the day of your assessment to describe the findings of the assessment. The report will provide recommendations to return to work, accommodations for the work place as well as rehabilitation/further treatment if needed. Reports preparation can take from 5 – 10 working days.
Referral and Payment for FCEs
People are generally referred for an FCE by a General Practitioners, Specialists (such as othopedic surgeons, neurologists, physicians) or Insurance representatives or the employer’s medical practitioners.
FCEs are paid for by the clients medical aid scheme, insurance companies, employers or by the client themselves