EEO: Lecture 2 Flashcards by Chavez Girls

Types of Tests and measures

Observations and Outcome measures

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2 types of outcome measures

Clinical Based and Patient-centered (Self-Report)

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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

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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”

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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

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what type of response is yes and no response?

nominal measures

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what type of response is measured in RANK order, not equal intervals?

ordinal measures

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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)

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what type of response has equal intervals between responses

interval/ratio measures

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what is an example of a interval response format?

ankle circumference, goniometry

(cannot have an ankle circumference of 0)

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what is an example of a ratio response format?

how many times do you of shopping each week?
0, 1,2,3,4,5…

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what is the difference between interval and ratio measures?

Interval: #’s start at 1
ratio: #’s start at 0

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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.

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a ______ instrument measures a phenomenon dependably, time after time, accurately, predictably, and without variation

reliable

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a tested measure should demonstrate:

test-retest stability
intra-rater reliability
inter-rater reliability

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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)

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is a nominal or ordinal response more reliable over time?

nominal

*ordinal has more choices –> less reliable

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is a nominal or ordinal response more sensitive (to detect change)?

ordinal

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face validity is

the idea that the instrument measures what it claims to measure

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content validity is

the idea that the subcomponents of the instrument adequately cover the entire construct

-does an ADL instrument cover all important ADLs?

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what effect results from an activity/questionnaire that is too difficult?

floor effect

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what effect results from an activity/questionnaire that is too easy?

ceiling effect

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“Did you run a marathon this week?” will produce a floor or ceiling effect?

floor: most people have not run a marathon

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the Berg Balance Scale will produce a floor or ceiling effect?

ceiling effect: Berg is east and does not evaluate walking

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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