EEO: Lecture 2 Flashcards
Types of Tests and measures
Observations and Outcome measures
2 types of outcome measures
Clinical Based and Patient-centered (Self-Report)
what are the pros of observation?
- you can see how the patient chooses to move on a regular basis
- can watch the patients emotional response with mvmt
-great for patients with communication difficulties
what are the cons to observation?
-takes clinical reasoning and further testing to relate findings to pt’s chief complaint
-patient may “put on a show”
Patient centered assessments (self-report): Pros and Cons
pros: info relevant to pt, wide range, easy, fast, inexpensive
cons: limited by pt interpretation, number of tasks limited, psychosocial factors, unintentional inaccuracy
what type of response is yes and no response?
nominal measures
what type of response is measured in RANK order, not equal intervals?
ordinal measures
What is an example of an ordinal measure?
measured in rank order not equal intervals
describe your ability to take a shower:
-no difficulty (0)
-some difficulty (1)
-unable to do so (2)
what type of response has equal intervals between responses
interval/ratio measures
what is an example of a interval response format?
ankle circumference, goniometry
(cannot have an ankle circumference of 0)
what is an example of a ratio response format?
how many times do you of shopping each week?
0, 1,2,3,4,5…
what is the difference between interval and ratio measures?
Interval: #’s start at 1
ratio: #’s start at 0
what type of response format is a patient satisfaction questionnaire?
1: strongly agree
2: agree
3: no opinion
4: disagree
5: strongly disagree
oridinal
The responses indicate a rank order, but the intervals between the points (e.g., the difference between “Agree” and “Strongly Agree”) are not necessarily equal or objectively measurable.
a ______ instrument measures a phenomenon dependably, time after time, accurately, predictably, and without variation
reliable
a tested measure should demonstrate:
test-retest stability
intra-rater reliability
inter-rater reliability
what is the difference between intra-rater reliability and inter-rater reliability?
intra-rater reliability: within the same rater (1 therapist)
inter-rater reliability: between raters (different therapists)
is a nominal or ordinal response more reliable over time?
nominal
*ordinal has more choices –> less reliable
is a nominal or ordinal response more sensitive (to detect change)?
ordinal
face validity is
the idea that the instrument measures what it claims to measure
content validity is
the idea that the subcomponents of the instrument adequately cover the entire construct
-does an ADL instrument cover all important ADLs?
what effect results from an activity/questionnaire that is too difficult?
floor effect
what effect results from an activity/questionnaire that is too easy?
ceiling effect
“Did you run a marathon this week?” will produce a floor or ceiling effect?
floor: most people have not run a marathon
the Berg Balance Scale will produce a floor or ceiling effect?
ceiling effect: Berg is east and does not evaluate walking
the amount of change in a variable that must be achieved to reflect a true difference, not by error or chance
minimal detectable change(statistical)
the smallest difference in a measured variable that signifies an important rather than trivial difference in the patient’s condition
minimal clinically important difference (clinical)
What is the draw back of the McGill Pain Questionnaire?
it is 20 questions long
Global disability/ QoL measures what?
patient’s overall disability (regardless of condition) or measures Quality of Life
Goal of QoL
To capture a broad range of health status facets
Global disability/QoL: Pros and Cons
Pros: applicable to a variety of pts, extensive normative data
Cons: sacrifice depth for broadness, irrelevance to some conditions, less sensitive to changes
SF-12 global disability/QoL scale
questionnaire that includes 12 questions that measure functional health and well-being across various domains.
ADL measures: Pros and Cons
Pros: overall function, real-world view
Cons: limited number of activities, too basic for some pt
ADL measures are dependent on what the ___________ identifies as essential
individual
ability type of scale
scales that go HIGHER with improvement
-ex: credit report
disability type of scale
scales that go LOWER with improvement
ex: golf, race times
the LEFS is a _______ scale type
ability
the qDASH is a ______ scale type
disability
Goals are written for each outcome measure based on what 2 things?
MCID and patients goal
Cognitive/Affect Measures: Pros and Cons
Pros: more detailed assessment in an area, wide range of clinical pop
Cons: may not change in response to PT, limited in scope
psychologically informed practitioner
a healthcare professional who integrates psychological principles and understanding into their clinical practice, particularly when addressing issues related to physical health, pain management, and chronic conditions
Goal of Diagnosis-Specific measures
assess the patient’s perception of the effect of a specific disease
Diagnosis-Specific measures: Pros and Cons
Pros: relevant content for condition, more likely to detect imp changes over time
Cons: applicable to specific pts, unlikely to detect changes in broad aspects of QoL
Arthritis Measures (2)
Arthritis Impact Measurement Scale – version 2 (AIMS)
Western Ontario McMaster Arthritic Category (WOMAC)
Spine Measures (3)
Oswestry Disability Index (ODI)
Roland Morris LBP Disability Questionnaire (RMQ)
Neck Disability Index (NDI)
what type of scale is the ODI?
disability scale : scores are LOWER with improvement
Global Upper Quarter Scales (2)
DASH/qDASH
Up Ex Functional Scale (UEFS)
Shoulder Area Scales (4)
Shoulder Pain and Disability Index (SPADI)- high score means LOW function
Scale of Shoulder Function-Flexilevel (Flex-SF)- high score high function
Simple Shoulder Test (SST)- high score high function
UCLA Shoulder Scale- high score high function
Hand Area Scales
Michigan Hand Questionnaire (MHQ)
Alderson-McGall Hand Function Questionnaire
Global Lower Quarter Scales (3)
Lower Extremity Activity Profile (LEAP)
Lower Extremity Function Scale (LEFS)
Lower Extremity Activity Scale (LEAS)
Hip Area Scales (1)
Harris Hip Function Scale
Knee Area Scales
Lysholm’s Knee Scoring Scale
Knee OA Outcome Scale (KOOS)
Foot/Ankle Scales
Foot Function Index (FFI)- high score high function
Foot and Ankle Disability Index (FADI)- high score LOW function
Foot and Ankle Outcome Scale (FAOS)- high score high function
Performance-Based Outcome Measures: Pros and Cons
pros: measurable, observe tasks, ID problem areas, appropriate psychometric properties
cons: improvements may or may not be relevant, time consuming, limited number of activities,
Aerobic Physical Perfomance tests
6 Min Walk test
Upper Quarter Test
Gait Locomotion tests
Dynamic Gait Index
TUG
Functional Gait Assessment
General Function Tests
Functional Independence Measure (FIM)
Balance Tests
Tinetti
Star Excursion Test
Y balance
Functional Reach
Region Specific Test
hand dynamometry
Time LE stand test
Biering Sorensen
Power Tests
seated throw
Athlete Tests
vertical jump
agility t-test
cross over hop
How do you determine gait speed?
10m walk test
Household ambulator cut off speed
less than .40 m/s
limited community ambulator cut off
0.40- LESS THAN .80 m/s
community ambulator cut off
greater than or equal to .80 m/s
True/False: An example of ordinal data is Rehab Prognosis: Excellent/Good/Fair/Poor?
true
You are evaluating your next patient. Which of the following is an immediate red flag that should be acted upon immediately?
angina with profuse sweating
You are evaluating a 63 year-old female patient who presents with a diagnosis of “muscle weakness”. The patient chart states she is a HIGH fall risk. Her patient goal is “to be able to get up from the chair like I could before”. After the subjective interview, you ask the patient to show you how well she can stand up from her chair, but she has difficulty performing one repetition. Of the following, which would be the MOST appropriate performance-based outcome measure to administer?
30 second sit to stand
Which of the following self-report outcome scales is NOT a global disability quality of life measure?
Beck Depression Inventory
You want to assess the overall lower quarter function of a 22 year-old athletic patient who recently had knee surgery. His patient goal is “to get back to playing football”. You wish to administer a self-report outcome measure that captures his current impairments of knee swelling, knee catching, and inability to fully extend the involved knee. Which of the following self-report outcome measures would be the BEST?
Knee Injury and Osteoarthritis Outcome score (KOOS)
You are chart reviewing your next re-evaluation patient as a student physical therapist. You notice the patient’s chart states the patient’s Quick DASH score is 3. Which of the following statements is TRUE?
The patient’s shoulder has very little to no pain, not dysfunctional, and no to little ADL limitation.
You are treating a 68-year-old male patient with impaired gait, difficulty initiating gait, difficulty making turns during ambulation, and difficulty rising from a chair. Their patient goal is “to be able to get up and move better”. Which of the following performance-based outcome measures would be the BEST to administer to properly capture their dysfunction?
TUG
True/False: An example of ratio data is Reflex grading: 0/1+/2+/3+/4+/5+?
false - it is ordinal data
True/False: True or false: An example of ordinal data is Manual Muscle Testing (NNT) Grades: 0, 1, 2, 3, 4, 5?
true
