Assessment Functional Status

• Functional status is ability to perform activities of daily living independently and effectively
• Domain

  • Activity of daily living
  • Instrumental activity of daily living
  • Morbidity and ambulation
  • Cognitive functioning
  • Social and emotional function
• Nutrition screening tool that incorporate with assessment of functional status :

  • Mini Nutritional Assessment (MNA)
  • Subjective Global Assessment
• Hand grip strength is validated surrogate measure of muscle store
• Limitation hand grip strength (MADV)

  • measurement require special equipment, equipment maintenance and clinical training
  • ability of individual to use dynamometer may affected by medical or surgical history
  • determinant of normal and abnormal measurement is not standardize, limit the clinician to compare the measurement
  • valid criteria for hand grip strength is under development
• Other possible measure include :

  • general performance status
  • able to participate physical therapy
  • able to perform activity of daily living
  • able to wean from ventilator
• 4 of the SGA questions in section A deals with questions of functional capacity.

  The goal is to differentiate between:

  1. No dysfunction in functional capacity (full capacity)

  2. Dysfunction in functional capacity

  If dysfunction is identified, SGA goes on further to assess:

  1. Duration of dysfunction (in # of weeks)

  2. Type of dysfunction (working suboptimally, ambulatory, or bedridden)