lecture1: intro eval and treat Flashcards
Stroke Impact Scale
participation measure! from patient’s perspective!
*questionaire about impairments, activity limits, QoL, stroke recovery
STREAM (stroke rehab assessment measure) is a ____
activity and BFS/impairment measure
supine to sit, standing, walking
The PASS is a…
activity AND impairment/BFS measure!
postural assessment scale for stroke
*can you sit? can you stand with/without support? stand on one leg? can you CHANGE POSTURE
What is the Barthel Index for chronically ill?
activity measure: MEASURES HOW MUCH BARTHEL NEEDS HELP
*score over 60 means you can care for self (but not live byself)
*score UNDER 60 NEEDS HELP
FIM is a….
ACTIVITY MEASURE
functional Independence measure
(evolved into IRF-PAI inpatient rehab facility patient assessment instrument)
FIM 7
complete independence
FIM 6
modified independence
FIM 5
needs supervision or set up
FIM 4
- needs help getting into/out of bed/chair
- patient needing only incidental help (CGA or steadying) which is 75% or more PATIENT WORKING
MIN ASSIST
FIM 3
mod assist! 50-75% PATIENT EFFORT
Patient giving at least half effort
FIM 2
MAX ASSIST
patient giving less than 50% (25-50) but not total assistance
FIM 1
TOTAL ASSIST
Even if walking independently 25 feet, if patient cannot go 50 feet, they are
TOTAL ASSIST score FIM1
Fugl Meyer is a…
impairment, functional limitation/disability measure for stroke!
*research
The FIST (function in sitting test), action reach arm test, and perception (line, clock, etc) tests are…
body function/structure stroke measurements
The trunk impairment scale is a…
BFS measure
*dynamic and static sitting balance (look at crossing leg, 10 seconds without arm support, trunk displacement 10 cm backwards….)
What are 6 outcome measures for TBI?
glasgow coma scale
JFK coma recovery scale
galveston orientation and amnesia scale
ranchos
UDS-MR FIM-FAM
disability rating scale
What are 7 movement system diagnoses?
- movement pattern coordination deficit
- force production deficit
- fractionated movement deficit
- postural vertical deficit
- sensory selection/weighting deficit
- hypokinesia
- dysmetria
Orpington prognostic scale
stroke prognosis for recovery (1.6-6.8)
If below 3.2-mild
If over 5.2-severe
CPG for locomotion post chronic stroke, incomplete SCI, TBI
clinicians SHOULD
- walk train at mod-high aerobic intensity
- walk train with virtual reality
CPG for locomotion post chronic stroke,
incomplete SCI, TBI
clinicians MAY CONSIDER
- strength train over 70% 1RM
- circuit training at 75-85% HR
- balance training with virtual reality
CPG for what to NOT DO cpg for locomotion post chronic stroke, incomplete SCI, TBI
- static/dynamic STANDING BALANCE (including pre-gait)
- BWSTT with kinematic emphasis
- robot-assisted gait training
When should you provide an AFO or FES post stroke?
Should for walking, dynamic balance, gait speed, (maybe for kinematics), CHRONIC walking endurance, CHRONIC strength issue
DO NOT FOR TONE/SPASTICITY
What are contrived activities?
things like total gym, PNF diagonals…
If doing contrived, go into FUNCTIONAL
Poor predictors for stroke
- Cognition:
-dementia
-global aphasia
-B&B - persistent sensory def
- severe visuospatial def
- history: previous stroke
- old age
MOVEMENT SYSTEM DIAGNOSES
- Mvmt pattern coordination deficit
- Force production deficit
- Fractionated movement deficit
- Postural vertical deficit
- Sensory selection/weighting deficit
- Sensory detection deficit
- Hypokinesia
- Dysmetria
- Cognitive deficit
PT interventions for concussion
- Identify motor function impairments (affecting balance, high level physical mobility)
- Use progressive symptom guided aerobic exercise to help with intolerance to ex
- Cervical/t spine dysfunction, vestibule-ocular dysfunction, dizziness complaints
- Graded progressions
What are the 6 core outcome measures recommended by APTA?
- BBS
- FGA
- ABC
- 10 meter walk test
- 6mWT
- 5XSTS
What are the StrokeEDGE ANPT recommendations for outcome measures?
- FIM
- Fugl-Meyer
- PASS
- SIS
- Trunk impairment scale
UDS-MR, now IRF-PAI is a measure of
Activity/participation limits
*INPATIENT REHAB FACILITY PATIENT ASSESSMENT INSTRUMENT
*general for everyone
When should you NOT provide an AFO/FES for post stroke?
Tone/spasticity
When should you NOT provide an AFO/FES for post stroke?
Tone/spasticity
When is it OKAY to use AFO/FES for post stroke?
Strength/mm activation with decreased stiffness
Walking endurance improvement
Gait kinematics
When SHOULD you use AFO/FES post stroke?
- Gait speed
- Dynamic balance
- Other mobility
- Chronic walking endurance issues
- Quality of life
- CHRONIC strength issues/mm activation
