Neuro PT Outcome Measures- Very common but not overtly recommended

Question 1

TUG

Answer 1

ICF: Activity

Observer
Assesses mobility, balance, walking ability, and fall risk

3M round trip to/from chair w/armrests

Can use AD- has to use it in all trials

Cutoff: “Older Stroke patients” >14”

MDC: 2.9”

o May demo less reliability among pts w/cog impairment
o Alzheimer’s MDC: 4.09 sec
o PD MDC: ~4 secs
o SCI MDC: 10.8 sec

Question 2

DGI

Answer 2

ICF: Activity

Observer
Assesses ability to modify balance while walking in presence of external demands

8 items involving gait

Score range 0-24
(4 pt scale 0=severe impairment, 3= no dysfx)

Cut-off (fall risk): <19 for other diseases

MDC:
» Chronic: 2.6 pts
» Acute/subacute: 4 pts

MCID: N/A for strokes (1.9 for community-dwelling older adults)

o FGA shows less ceiling effect and is recommended over DGI in stroke population (Lin et al, 2010)
o DGI has ceiling effect in people w/vestibular dysfx (Wrisley 2003)
o PD Cut-off: <19 more likely to fall, MDC: 2.9 pts
o MS Cut-off: <12 indicative of fall-risk in 1 study, <19 in another study; MDC: 4-5 pts
o Vestibular cut-off: <19 = 2.58 times more likely to have reported a fall in previous 6 months; MDC: 4 pts

Question 3

Functional reach test

Answer 3

ICF: Activity

Performance Measure
Assesses stability

Stand close to wall; 90* shoulder flexion, closed fist, 3rd metacarpal (modified= sitting)—other modifications available

5 total trials, average last 3

Cut-off: Not established
MCD: Not established

MCID:
» 6.79 cm
» 2-3 cm for modified

o PD cut-off: 25.4 cm= fall risk; MDC varies 4-8 cm
o Vestibular MDC= ~6cm
o SCI MDC= 4-5 cm

Question 4

Modified Ashworth Scale (AS assesses antispasticity drugs on spasticity in MS)

Answer 4

ICF: Body structure, Body fx

Stroke EDGE II: NOT R or HR

Tests resistance to passive movement about a joint w/varying velocity

0 No increase in tone
1: Slight increase w/catch OR min resistance at EROM
1+: Slight increase w/catch with min resistance t/o remainder (<1/2 ROM)
2: More marked increase in tone t/o most of ROM but easily moved
3: Considerable increase, PROM difficult
4: Rigid

MCID: Response to botox: ~1 pt decrease on MAS

Question 5

Mini Mental State Exam

Answer 5

ICF: Body Fx

Observer
Quantitative assessment of cog impairment to record changes over time

11 questions/tasks in 7 cog domains

Score range 0-30

Cut-off:
» <24= cog impairment
» Mild: 18-24
» Severe: 0-17

MDC for CVA: Not established
MCID for CVA: Not established

o more prone to ceiling effects than MoCA—may not be as sensitive to mild cog impairment
o Alzheimer’s and Dementia MCID: 1-3 pt decrease in MMSE indicative of meaningful decline
o Neurocognitive d/o’s and PD MDC: ~6 pts