Fxnal Exam Flashcards
Pros and cons of defining levels of assistance:
Pros: familiar to healthcare providers, quick, simple
Cons: somewhat subjective, does not describe quality of mvmnt
Describe the GUG test:
Get Up and Go Test: developed as a quick screening tool for detecting balance problems in the elderly.
Requires that subjects stand up from an arm chair, walk 3 meters, turn around, and return to sitting in the chair. As assistive device may be used.
Describe the GUG test scoring:
Performance scored according to the following scale:
1 = normal
2 = very slightly abnormal
3 = mildly abnormal
4 = moderately abnormal
5 = severely abnormal
Increased risk for falls found in older adults who score 3 or higher
Describe the TUG:
Time to complete performance of the test is measured. Designed to detect BOTH functional mobility deficits as well as predict fall risk.
The TUG primarily examines _____ aspects of postural control associated with rising from a chair, turning and sitting down.
Proactive or Anticipatory aspects of postural control
What components of postural control are NOT tested with the TUG?
Sensory components of postural control are NOT manipulated during the test
Per authors, neurologically intact adults who are independent in balance and mobility skills are able to perform the TUG in less than __ sec.
< 10 sec
Shumway-Cook found that if score > __ sec on TUG, high risk for falls in community dwelling elders.
> 14 sec
Adults with neurologic pathology who took > __ sec to complete the TUG are likely to be dependent in most ADLs and mobility skills.
> 30 sec
Describe scoring criteria for the TUG:
Time for ‘Up and Go’ test __ sec.
Unstable on turning? _________
Walking aid used? _______ Type of Aid: ___________
Which broad areas is the TUG validated for measuring?
fxnal mobility
falls risk
Describe the reason TUG DT is used:
Dual task: By adding a secondary task to the TUG, clinicians can examine the effect of cognitive demand on anticipatory aspects of postural control. Originally created to see if adding a secondary task would increase the sensitivity and specificity of the TUG as a measure of fall risk in community-dwelling older adults
Describe the TUG DT Cognitive component:
Subjects were asked to complete the TUG while counting backwards by 3’s.
Describe the TUG DT Manual component:
Subjects were asked to complete the TUG while carrying a cup of water.
How is the TUG DT performed?
Patients are timed (in seconds) when performing the TUG in 3 conditions: alone, cognitive, manual
How has the TUG been adapted for use in peds?
Concrete task: children asked to touch target on the wall (abstract instructions shown to limit performance in children with CP).
Repeated instructions: Children allowed to behave spontaneously, so no qualitative instructions were given.
Change in stop/start time: Timing started as bottom leaves seat rather than on command “go” in order to solely movement time. Child seated with feet flat, 90 degree angle.
The PEDI TUG has been shown to be reliable for use in which populations?
Reliable in children without disability aged 3-9 y.o.
Reliable in young people with physical disability aged 3-19 y.o. (in Myelodysplasia (Spina Bifida) and CP).
Timed fxnal mvmnts are used to:
Objectively measure functional performance in any patient.
Consider safety, tracking progress, performance w/ and w/out meds, etc.
Describe the ACIF:
acute care index of fxn: 20-item test developed to standardize the fxnal assessment of pts with acute neurologic conditions.
(12-15 minutes)
What are the 4 subgroup items that the ACIF tests?
mental status
bed mobility
transfers
mobility
ACIF reliability?
Excellent reliability with acute neuro patients
The CS-PFP looks at:
Ordinary activities of daily life, performed at maximum effort within the bounds of safety and comfort.
Designed to provide a comprehensive, in-depth measure of physical fxn that reflects abilities in several separate physical domains.
What does the CS-PEP include?
15 tasks performed in sequential order from easiest to most difficult.
How is the CS-PEP scored?
Uses RPE throughout the test.
Test yields a total score (0-100) that is the average of five separate physical domain scores: upper body strength, lower body strength, flexibility, balance, coordination, and endurance.
CS-PFP psychometric properties:
Valid, Reliable, and sensitive measure of physical function that is applicable to a wide range of functional levels.
Can be used to evaluate, discriminate, and predict physical functional performance for both research and clinical purposes.
CS-PFP stands for
continuous scale physical fxnal performance test
WST stands for
wheelchair skills test
WST is intended to test:
specific person in a specific wheelchair in a standardized manner.
WST is used as:
- diagnostic measure early in course of rehab program to create POC
- also used as an outcome measure
Age range for FAC?
Adults: 18-64 years
OGA stands for
observational gait assessment
What is OGA used for?
Organized approach to observing joint movements, timing of movements and quality of movements during walking.
In elderly, OGA and gait speed are predictive of:
- Hospitalization for any cause
- Requirement for a caregiver, nursing home placement
- Falls and Fractures
- Death in healthy elderly persons
What is the best method of calculating gait velocity?
One commonly used tool validated and reliable in neurological populations is the 10 Meter Walk Test
(Stroke, SCI, PD)
What does HiMAT stand for?
high level mobility assessment tool
What is the population HiMAT is specifically designed for?
Assesses high-level mobility in people who have sustained a TBI, but is being used by some clinics for other neurological populations.
What does HiMAT test?
20m walk, walking backwards, walking on toes, walking over an obstacle, 20m run, 20m skipping, 10m hopping, bounding on affected and less affected leg, up stairs, down stairs.
