Download Clinical Usefulness of the Kettle Test in Conjunction with the

Clinical Usefulness of the Kettle Test in Conjunction
with the Montreal Cognitive Assessment in a
Neurosurgical Population
Lauren Nichols, Rowan Castle, Jolene May, Leeza Hawkins, Christy Dorward
Royal Hobart Hospital
Outline
• Assessment of cognition and functional cognition
• The Kettle Test
• Comparing the Kettle Test to the Montreal Cognitive Assessment
Cognition and Daily Function
(Sloan & Ponsford, 2008; Hartman-Maeir,
Harel & Katz, 2009; Unsworth, 2010;
Grohol,2014)
Schools of Thought
standardised
functional cognition
observation
(Pascale Toglia, Golisz & Goverover, 2009; Unsworth, 2010)
pen & paper
Occupational Performance
Self-care
Instrumental ADLS
Habits & Routines
Less Cognitively Demanding
Novel & Challenging Tasks
More Cognitively Demanding
(Bear, Connors, & Paradiso, 2007; Coster, Haley, Jette, Tao & Siebens, 2007; Sloan &
Ponsford, 2008; Pascale Toglia, Golisz & Goverover, 2009)
(Bear, Connors, & Paradiso, 2007; Baum & Katz, 2010)
Utility of Different Assessments
Standardised
Pen & Paper
Tests
Observation of
Routines & Habits
Standardised
Functional
Assessments
Tests
Isolated pre-frontal
functions
Procedural memory
Integration of pre-frontal
functions
Tells Us
Presence of a cognitive
deficit
Task specific capacity
Cognitive capacity for
activities
(Sloan & Ponsford, 2008; Pascale Toglia, Golisz & Goverover, 2009;
Baum & Katz, 2010)
The Kettle Test
(Hartman-Maeir, Harel & Katz, 2009)
The Kettle Test
“To evaluate the ability for
independent community living
of people with
identified or suspected cognitive disabilities”
(Hartman-Maeir, Armon & Katz, 2005; Hartman-Maeir, Harel & Katz,
2009; Baum & Katz, 2010)
Kettle Test Outline
Making 2 different hot drinks
(Hartman-Maeir, Harel & Katz, 2009)
Scoring
• Total score 52
• Higher scores indicate more impairment
• Functional interpretation - The Global Independence Score
① Independent
② Mild Assistance
③ Significant assistance
(Hartman-Maeir, Harel & Katz, 2009)
Study Aims
MoCA
Kettle
Sample Population
• Tasmania Neurosurgical Unit
• State-wide service
• Population:
•
Post-surgical
&
Mild-moderate head injuries
Variables
Age
Diagnosis
Surgery
MoCA
Kettle
Discharge Destination
OT Intervention
Methods
• 30 neurosurgical case files
• Retrospective file audit of sample population
• Qualitative methodology
– Exploratory case study
– Pattern matching
Results
60% Cases (n=18)
MoCA
Kettle
Both either: no impairment, mild impairment, or severe impairment
Results Continued
40% Cases (n=12)
Cognitive Impairment
Functional Cognitive Impairment
(n=5)
(n=7)
 MoCA
✔ MoCA
✔ Kettle
 Kettle
Results Continued – Role of OT
Observation and analysis of activities
Case Study
Bob
• 80 years old
• Independent
• Tertiary educated
• Traumatic subdural
haemorrhage & burr holes
Case Study
OT Assessment
Functional Cognitive Impairment
✔ MoCA – 30/30
 Kettle – Severe Impairment
Showed difficulties managing:
Self Care Tasks
Money
Medications
Unsafe Situations
Reflections
1. Cognitive impairments can exist without functional implications
– Minor Neurocognitive Disorder - DSM V
2. Montreal Cognitive Assessment
– does not consistently predict functional cognitive deficits
3.
Kettle Test + Montreal Cognitive Assessment
– more robust assessment of cognition following a neurological
event.
Lauren Nichols
[email protected]
References
•
•
•
•
•
Baum, C. M., & Katz, N. (2010). Occupational therapy approach to assessing the relationship between
cognition and function. In T. D. Marcotte & I. Grant (Eds.), Neuropsychology of everyday functioning (pp. 6292). New York: The Guildford Press.
Bear, M. F., Connors, B. W., & Paradiso, M. A. (2007). Memory systems. In M. F. Bear, B. W. Connors &
M. A. Paradiso (Eds.), Neuroscience: Exploring the brain (3rd ed., pp.725-760). Philadelphia: Lippincott
Williams & Wilkins.
Coster, W.,Haley, S. M., Jette, A., Tao, W., & Siebens, H. (2007). Predictors of basic and instrumental
activities of daily living performance in persons receiving rehabilitation services. Archives of Physical Medicine
and Rehabilitation, 88(7), 928-935.
Grohol, J. (2014). Symptoms of Minor Neurocognitive Disorder. Psych Central. Retrieved on November 1,
2015, from http://psychcentral.com/disorders/symptoms-of-minor-neurocognitive-disorder/.
Hartman-Maeir, A., Harel, H., Katz, N. (2009). Kettle test- A brief measure of cognitive functional
performance: Reliability and validity in stroke rehabilitation. The American Journal of Occupational Therapy,
65(5), 592-599.
References
•Hartman-Maeir, A., Armon, N., & Katz, N. (2005). "The Kettle Test: A cognitive functional screening test."
Unpublished protocol, Helene University, Jerusalem, Israel.
•Nasreddine, Z. S., Phillips, N. A., Bedirian, V., Charbonneau, S., Whiltehead, V., Collin, I., Cummings, J. L., &
Cherthow, H. (2005). The Montreal Cognitive Assessment: MoCA: A brief screening tool for mild cognitive
impairment. Journal of the American Geriatrics Society, 53(1-2), 695-699.
•Pascale Toglia, J., Golisz, K. M., & Goverover, Y. (2009). Evaluation and intervention for cognitive perceptual
impairments. In E. B. Crepeau, E. S. Cohn, & B. A. B. Schell (Eds.), Willard and Spackman’s occupational therapy
(11th ed., pp. 739-776). Philadelphia: Lippincott Williams & Wilkins.
•Sloan, S., & Ponsford, J., (2008). Assessment of cognitive difficulties following TBI. In J. Ponsford (Ed.),
Traumatic brain injury: Rehabilitation for everyday adaptive living (4th ed., pp. 65-102). New York: Psychology Press
Ltd.
•Unsworth, C. A. (2010). Cognitive and perceptual strategies. In M. Curtin, M. Molineux, & J. Supyk-Mellson
(Eds.), Occupational therapy and physical dysfunction: Enabling occupation (6th ed., pp. 607-635). Edinburgh:
Churchill Livingstone Elsevier.