Balance and gait outcome measures

Question 1

Medical problems that could cause a fall

Answer 1

MSK
Neurological
Cardiovascular
Altered mental status
Peripheral neuropathy
Sensory changes
Medications
Environmental factors: clutter, obstacles etc

Question 2

Impairments related to falls

Answer 2

Strength
ROM
Muscle length
Posture
Vestibular
Sensation
Cognition
Vision
endurance /tolerance to activity
Fall history
Confidence level
Balance, stability and control
Anticipatory control strategies
Reactive control strategies

Question 3

Functional balance grades

Answer 3

• normal = 4
• good = 3
• fair = 2
• poor = 1
• absent = 0

Question 4

Normal (4) rating

Answer 4

able to maintain without handhold support/accepts maximal challenge and can shift weight easily

Question 5

Good (3)

Answer 5

– Able to maintain without handheld support with limited sway/accepts moderate challenge, can pick object off of floor

Question 6

Fair (2)

Answer 6

– able to maintain with handheld; may require occasional min assist/accepts minimal challenge, able to maintain while head/trunk turning

Question 7

Poor (1)

Answer 7

– requires handheld support and mod to max support to maintain position/unable to accept a challenge without LOB

Question 8

Absent (0)

Answer 8

– unable to maintain balance

Question 9

Floor effect when choosing the right test

Answer 9

too hard and scored too low to give any good information

Question 10

ceiling effect when choosing the right test

Answer 10

too easy and scored too high to given information

Question 11

What are factors that impact which test you choose

Answer 11

• Intent of testing (balance, gait, confidence, fall prevention strategies)
• Cognition
• Time and resources
• Facility directed instruments

Question 12

Reliability: determining quality of instrument

Answer 12

assures consistency/is it consistent and produces comparable values

Question 13

Validity: determining quality of instrument

Answer 13

assures accuracy/does it measure what is should measure
Want a gait test you should look at a gait test

Question 14

MDC:

Answer 14

• minimal detectable change
• Can vary based on diagnosis
• Minimal change that reflects statistically significant change
• Matters to the researcher → reflects true change

Question 15

Types of reliability and describe

Answer 15

1. Test-retest: do it once and then do it again do you get similar values
2. Intra-rater: within raters; if I follow it today will it be accurate when I do it again
3. Inter-rater: within many tests

Question 16

MCID

Answer 16

• minimal clinical important difference
• The smallest change in a treatment outcome that an individual patient would identify as important
• Matters to the client → they see change in function or management

Question 17

TUG scoring cut offs

Answer 17

• <10 seconds - Normal
• 10-20 seconds – typical of elderly or mild disability
• > 30 seconds – Frail, impaired mobility, high fall risk.
• Assistance recommended

Question 18

Tinetti Risk of falls score

Answer 18

• Max score 28
• ≤18/28 high risk of falls

Question 19

berg balance test scores

Answer 19

• Berg Balance Test 2
• Max Score 56
• <50/56 indicates fall risk
• ≤40 indicates almost 100% risk of falls

Question 20

DGI scoring

Answer 20

• Max score 24
• <19/24 – predictive of falls

Question 21

10 m walk test scoring

Answer 21

• Normal pace ≥ 1m/sec (3.3feet/sec)
• < 0.7 m/sec suggests increased dependency/↑
  likelihood of falls
• < 0.4m/sec household ambulator
• 0.4-0.8m/sec community ambulator
• > 0.8 community ambulator