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Rehabilitation Engineering I > Lecture 10 - Transfer to Clinics > Flashcards

Lecture 10 - Transfer to Clinics Flashcards

1
Q

What are possible secondary complications of a stroke?

A
  • muscle atrophy
  • cardiopulmonary problems
  • pressure sores (decubitus)
  • osteoporosis
  • incontinence
  • mortality
  • patient is not active more than 90% of the time
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2
Q

How can intensity of training be increased?

A 
Number of repetitions
- duration
- frequency/speed
Physical effort
- strength
- guidance
- assistance
Mental effort
- task-specific
- challenge
- reward
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3
Q

What is the equation for intensity of training?

A

intensity = # repetitions * physical effort * mental effort

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4
Q

What is Evidence-Based Medicine?

A

1) EBM is an approach to medical practice intended to optimize decision-making by emphasizing the use of evidence from well-designed and well-conducted research. Only the strongest types coming from meta-analyses, systematic reviews and randomized controlled trials can yield strong recommendations.
2) EBM integrates clinical experience and patient values with the best available research information. It is a movement which aims to increase the use of high quality clinical research in clinical decision making.

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5
Q

What is Evidence-Based Medicine based on?

A

It is based on assessments (recordings, test scores, questionnaires).

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6
Q

Give the 3 main types of clinical assessments with examples.

A
  1. Conventional Technical Measurements
    - active ROM
    - passive ROM
    - muscle strength
    - EMG supported measures
  2. Qualitative Clinical Scores
    - impairment based (e.g. Fugl-Meyer Assessment)
    - spasticity (e.g. Ashwort Score)
    - functional tests (e.g. Wolf-Motor Function Test, Box and Block Test)
  3. Assessment of Activity and Participation in Daily Life, Quality of Life
    - Motor Activity Log (MAL), Barthel Index, Stroke Impact Scale
    - Goal Attainment Score
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7
Q

Give an advantages and 3 disadvantages of robot-based vs. conventional asessments.

A

+ Robot-based assessments are quantitative, and thus can be more sensitive and accurate and better comparable between patients and raters

  • Robotic assessments are far from standard; need to translate outcomes to common language
  • Most clinical assessments have been used for many years and have been thoroughly tested and validated
  • Clinical assessments are usually easier to administer and usually require less and simpler equipment
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8
Q

What are good criteria to evaluate a clinical assessment?

A
  • Inter/intra-rater reliability
  • Test-retest reliability
  • Ceiling/flooring effects
  • Internal consistency
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9
Q

What is the Minimally Detectable Change (MDC)?

A

A statistical estimate of the smallest amount of change that can be detected by a measure that corresponds to a noticeable change in ability.

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10
Q

What is the Minimally Clinically Important Difference (MCID)?

A

The smallest change in a treatment outcome that an individual patient would identify as important and which would indicate a change in the patient’s management.

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11
Q

Describe the Flugl-Meyer Assessment.

A
  • stroke-specific, performance-based impairment index
  • 3 pt. ordinary scale (0=cannot perform, 1=performs partially, 2=performs fully)
  • 2 impairment domains (upper extremity, lower extremity)
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12
Q

Describe the Stroke Impact Scale.

A
  • measure of health status following stroke
  • 5 pt. scale on how difficult it is for the patient to complete a task
  • 8 domains
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13
Q

What are the 8 domains of the Stroke Impact Scale?

A
  1. Strength
  2. Hand function
  3. ADL/IADL (Activities of Daily Living / Instrumental Activities of Daily Living)
  4. Mobility
  5. Communication
  6. Emotion
  7. Memory and Thinking
  8. Participation/Role function
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14
Q

Describe the Goal Attainment Scale.

A
  • outcome measure involving goal selection and goal scaling that is standardized in order to calculate the extent to which a patient’s goals are met
  • each patient has his/her own outcome goal
  • successful outcomes are agreed upon prior to intervention
  • 5 pt. scale (0 = expected level, +1 = more than expected, +2 = much more than expected, -1 = less than expected, -2 = much less than expected)
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15
Q

Give 3 examples of clinical assessments for the upper extremities.

A
  1. Hydraulic dynamometer
  2. Box and Block Test
  3. 9-Hole Peg Test
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16
Q

Describe the Wolf Motor Test.

A
  • quantitative measure of upper extremity motor ability through timed and functional tasks
  • 17 items (time, functional ability, strength)
  • 6 pt. scale (0=does not attempt, 5= movement is normal)
  • all tasks are performed as quickly as possible and truncated at 120 sec.
17
Q

List 6 clinical assessments for gait performance.

A
  1. Functional Gait Assessment
  2. 6 Minute Walk Test (Walking capacity)
  3. 10 Meter Walk Test (Walking speed)
  4. Timed Up and Go (TUG)
  5. Beig Balance Scale
  6. Functional Mobility Scale
18
Q

What does the Functional Gait Assessment measure?

A

Postural stability during various walking tasks

19
Q

What does the 6 Minute Walk Test measure?

A

Distance walked over 6 min. Sub-maximal test of aerobic capacity/endurance.

20
Q

What does the 10 Metre Walk Test measured?

A

Walking speed in metres per second over a short duration.

21
Q

What does the Timed Up and Go test measure?

A

Mobility, balance, walking ability and fall risk in older adults

22
Q

What does the Beig Balance Scale measure?

A

It is a 14-item objective measurement to assess static balance and fall risk in adults.

23
Q

What does the Functional Mobility scale measure?

A
  • for children with CP aged 4-18 years

- rating 1-6 (1=wheelchair, 6=independent walking on all surfaces)

24
Q

List some questions relevant to evaluating the efficiency of therapy.

A
  • How many more patients can be treated by one therapist using robot(s)?
  • When get the purchase costs for robot subsidized?
  • How can costs of use of robots be reimbursed?
  • What are the effects of the use of robots for the health insurance system?
  • What are the effects of the use of robots for the national economy?
25
Q

Give the formula for session efficiency.

A 
Eff_session = t_training / ( t_training + t_setup )
Eff_session = t_training / t_session
26
Q

Give the formula for therapist efficiency.

A

Eff_therapist = n_patients / n_therapists

27
Q

Give the formula for therapy efficiency.

A 
Eff_therapy = Eff_therapist x Eff_session
Eff_therapy = (t_training x n_patients) / (t_session x n_therapists)

Rehabilitation Engineering I (12 decks)

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