Neuro PT Core Outcome Measures Flashcards
Berg Balance Scale
Recommended for static and dynamic and standing balance assessment
ICF: Activity
Performance Measure
14 items, scores 0-4 each
pts deducted for requiring supervision, assist, and increased time
AD’s shouldn’t be used
Score range 0-56
Lowest category that applies should be marked
Cut-Off: (Per Academy of Neuro PT pocket guide)
<40: almost 100% fall risk
<50 fall risk
MDC: (Per Academy of Neuro PT pocket guide)
Acute: 6-7 pts
Chronic: 4.66 to 6.7 pts
MCID: Not established
o May be better suited for use w/acute stroke patients b/c of ceiling
o SCI: scores not associated w/# of falls, not able to discrimate fallers from non-fallers
o PD cut-off: <52 more likely to fall; MDC= 5 pts
o Vestibular cut-off: <45 balance impairment
o Dementia MDC: 1.92
Functional Gait Assessment
Recommended for walking balance assessment
ICF: Activity
Rec strength strong for acute and chronic, mod for chronic progressive
10 items scored 0-3
Should walk without Assist
Document AD/bracing
Lowest category that applies should be marked
Cut-Off:
» <22/30= risk of falls (non-specific older adults)
» <15/30 PD
MDC:
» 4.2 stroke
» 6 Vestibular
MCID: Not established for strokes, but 4 pts for older adults and 4.3 in PD
Activities Specific Balance Confidence Scale
Recommended for balance confidence assessment
ICF: Activity
Rec strength strong for all acuities
Self-report/interview measure
16-items, score VAS 0-100 (100= complete confidence)
Overall score calculated by summing and dividing by total # of items completed
Cut-Off:
» Stroke (chronic): 81.1%= didn’t have hx/o multiple falls
» PD= <69% predictive of recurrent falls
» Older adults <67% fall risk, >80% high level fx, 50-80% mod level fx, <50% low level fx
MCD:
» 14%
» 13-30% for PD (depending on study)
MCID: Not established
o PD MDC: 11 or 13 diff’t studies
o Vestibular cutoff: <67% indicates a risk for falling
10M walk test
Recommended as Walking speed assessment
ICF: Activity
Rec strength BEST PRACTICE for acute, strong for other acuities
Performance measure
Assesses walking speed in m/s
2 trials at comfortable speed, then 2 trials at fasting speed
AD can be used, can provide assist
Average of each speeds documented (in m/s)
Document AD and assist level
Cut-Off:
» .8 commmunity ambulator
MDC:
» Acute: .11 m/s
» Chronic: .18 m/s (comfortable), .13 m/s (fast)
MCID
» Smallest meaningful change: 0.06 m/s
» Substantial: 0.14 m/s
o SCI MCID: .06 m/s
o TBI MCID: change reflected by 0.15 and 0.25 m/s increase in comfortable and fast-paced walking speed, respectively
6 Min Walk Test
Recommended as walking distance assessment
ICF: Activity
Rec strength best practice acute, moderate chronic, strong chronic progressive
Observer
Assesses distance walked over 6 mins as sub-max test of aerobic capacity/endurance
May take standing rest breaks, but record # of breaks; can use AD, and assist
Normative values community-dwelling elderly: ~570m 60-69 yos, ~500m 70-79 yos, ~400m 80-89 yos
MDC: ~35 meters
MCID: chronic: 34.4 m
o Alzheimers MDC: 33.47m
o PD MDC: 82 meters
o SCI MCD: 45.8m or 22% change
5 times Sit to Stand
Recommended as transfer assessment
ICF: Activity
Expert opinion evidence (V); Rec strength best practice
Score is amt of time it takes for pt to transfer seated to standing to sitting five times with arms folded across chest and back against chair
0 given if needs arms, can time it and document but is not official
Cut-Off:
» >12” discriminates healthy adults from individuals w/stroke
» PD: >16 fallers
» Vestib: >13 balance dysfx (and if <60 yo >10 balance dysfx
PD MDC: 2.4”
Vestib MCID: >2.3”
Goal Attainment Scale
ICF: Body fx, activity, participation, environment
Expert opinion evidence (V); Rec strength best practice
Patient reported outcome
Scoring: Each goal is rated on a 5-pt scale: \+2= much more than expected \+1= somewhat more than expected 0= patient achieves expected level -1= somewhat less than expected -2= much less than expected
overall score is calculated by incorporating the goal outcome scores into a single aggregated t-score
