Functional Mobility Assessment Flashcards
Functional Mobility Assessment
Ability to move safely and independently in various environments to accomplish functional activities or ADLs.
Need balance for functional mobility.
Includes a combination of flexibility/joint mobility, balance/stability, speed, reaction time, coordination, strength.
Balance and Functional Mobility
Both are…
-crucial for maintaining independence and reducing falls risks.
-impairment of either significantly associated with disability in older adults.
-training both aspects together can enhance overall mobility
Some Assessments of Functional Mobility
High-level Mobility Assessment tool (HiMAT)
Timed up and go (TUG)
Balance evaluation systems test (BESTest)
Mini-BESTest
Functional mobility screen (FMS)
Sit and reach
Star excursion balance test (SEBT)
Side-step test
30s Sit to Stand
5x Sit to stand
Y Balance test
Multiple single-leg hop stabilization test
Functional Mobility Scale
Used to help assess functional mobility without doing assessments (very common, overarching scale example).
0 = full activity
1 = walking with assistance
2 = walking with assistance for short periods
3 = walking with assistance for activities of daily living/appointments only
4 = confined to a wheelchair
5 = bedridden
High-Level Mobility Assessment Tool (HiMAT)
Used to assess clients with high level balance and mobility deficits such as those with traumatic brain injuries, neurological conditions, and MSK conditions that affect vestibular and motor function.
-higher level functioning clients = need to be able to walk 20m independently without gait aids.
consists of 12 items that evaluate various mobility tasks including walking, running, hopping, and stair navigation.
-total score 54 points = higher score indicates better mobility
Timed Up and Go (TUG)
Assesses mobility, balance, and falls risks for older adults
-slower times predict higher falls risks
-good for tracking clinical changes over time
-can observe walking gait at same time
TUG Scoring
A score of < or equal to 10s is considered normal.
>10s indicates increased falls risk and frailty
TUG Protocol
Client stands up from standard chair (make sure chair is up against a wall/secure.
-if arm rests or mobility aid is used note this down.
-initiate timing when client starts to stand up.
Client walks 3m (10 ft) at a normal pace, then turns around and walks back to the chair.
The time stops when client fully sits back down in the chair.
Complete 3 trials and use the fastest time.
BESTest
Intended for older adults, neurological conditions, cognitive impairments, vestibular conditions.
Require a lot of equipment.
-table for sitting, meter stick, step stool, weights (5 lbs and 3 lbs), foam block, ramp, obstacle, stopwatch, and a large walkway.
~30min to complete
36 items split into 6 categories:
-biomechanical constraints
-trainsitions
-sitting stability
-sensory orientation
-reactive postural response
-stability in gait
4 point scoring (0-3)
-0 = severe impairment
-3 = no impairment
Mini-BESTest
14 items split into 4 categories.
-3 point scoring (0-2), total of 28 points
-~10 min to complete
Tasks include…
-Sit to stand
-Rise to toes
-Stand on one leg
-Step forward compensation
-Step backward compensation
-Step lateral compensation
-DL stance (feet together) eyes closed
-DL stance (feet together) eyes closed on foam
-Stand on incline eyes closed
-Change in speed walk
-Walk with head turns
-Walk with pivots
-Step over obstacle
-TUG with dual task
Functional Mobility Screen (FMS)
Standardized screening tool used to assess fundamental movement patterns and identify functional limitations or asymmetries.
-useful for athletes as an injury prevention tool or basic movement screen.
7 movements, each scored 0-3 (total possible points = 21)…
-deep squat
-hurdle step
-incline lunge
-shoulder mobility
-active straight leg raise
-trunk stability push up
-rotary stability
Scoring for FMS
0 = indicates pain during the movement or unable to do the movement.
1 = unable to complete the movement or get into the correct position
2 = able to complete the movement but with compensation
3 = optimal movement with no compensation detected
Higher overall score = better movement quality and lower injury risk.
-a score of <14 may indicate a higher risk of injury poor body mechanics
-for tests involving bilateral movements, the lower score between left and right sides is recorded
Sit and Reach Test
Widely used test for flexibility of hamstrings and lower back.
Low scores can indicate risks of lower back pain or poor back health and lack of spinal mobility which may limit ADL.
Sit and Reach Test Protocol
The client sits on the floor with legs extended and bare feet against a sit and reach box or flat surface (but not a wall).
-do not allow client to perform jerky/ballistic movements
Client reaches forward as far as possible along a measuring device.
-if not using a box, the client’s toes measure at 26 cm to start, if fingers reach beyond toes then it is a positive score/if they do not reach past their toes then still measure but it is a negative score.
The best score out of three trials is recorded to the nearest 0.5cm
Norms associated with scores.
Star Excursion Balance Test (SEBT)
Assesses dynamic balance, lower limb strength, proprioception, and joint mobility of ankle, knee and hip.
-good to assess athletes with higher risk lower limb injuries or ankle instability or dynamic balance issues due to lower limb conditions.
Maintain balance on one leg while reaching as far as possible with other leg in 8 directions.
-anterior, anteromedial, medial, posteromedial, posterior, posterolateral, lateral, and anterolateral
Can compare both sides
Can also see strength balance and ROM between sides.
Protocol for SEBT
Place strips of tape on the ground at 45 degree angles in star pattern.
The client stands on one leg at the center.
Using the non-standing leg, the client reaches as far as possible in each direction, lightly touching the tape with their toes.
-Mark the most distal point of contact on the distance and record if needed.
-repeat the process for all eight directions
Three full circles
