Neuro Spreadsheet 2 (second part) Flashcards
TUG
Detects balance problems that affect daily mobility skills in adults, and test functional ambulatory mobility including balance and difficulty turnign during gait of children with or without physical disabilities and to monitor change over time
General info about the test (may include brief scoring summary)
Have an arm chair with line on floor 3 meters away (an assistive device may be used). A practice trial may be given, but have the individual rest for a few seconds. The starting position is when the individual’s back is against the back of the chair and arms on arm rests. Instruct, “When I say 1, 2, 3, GO, I want you to stand up, walk at your normal speed to the line on the floor, turn around, and walk back to the chiar, and sit back down with your back against the back of the chair.” Have the individual assume the start position and repeat the instructions and perform 2 trials. Average the time of both trials (in seconds) and interpret scores. In older adults
<20 seconds (estimate) = functionally independent in basic ADLs
20-30 seconds (estimate) = “grey area”, variable functional abilities
>30 seconds (estimate) = functionally dependent in basic ADLs and mobility skills. The mean score for preschoolers is 6.7 seconds and the mean score for primary school children is 5.1. Mean TUG score for children without physical disability was 5.9 seconds (SD 1.3).
Age ranges of test
Children age 3-9 years. Adults 60-101 yr.
Differences between pediatric and adult test procedures? In pediatrics no MCID is esatblished. The children are asked to rise from the chair and touch a target (usually a star). The child is not instructed on how fast to walk and the timer is started when the child’s bottom leaves the chair and is stopped when the child’s bottom touches the chair again. The chair used is a heigth that supports hip and knee flexion of 90 degrees and doesnt have arms on the chair. In adults, the timer starts when their back leaves the chair and stops when the back returns to the original position against the back of the chair. The chair has arm rests and both procedures require a marking 3 meters away.
Berg balance
Assess static balance and fall risk in adult populations.Examines functional balance in the context of everyday tasks in the pediatric population
General info about the test (may include brief scoring summary)
The Berg Balance test consists of 14 items rate on a 0-4 scale. The tester demonstrates each task and gives instructions as written. When scoring, record the lowest response category that applies for each item. In most iteims, the client is asked to maintain a given position for a specific time. Progressively more points are deducted if the time or distance requirements are not met, if the client’s performance warrants supervision, or if the client touches an external support or receives assistance from the examiner. Clients should understand that they must maintain their balance while attempting the tasks. The choices of which leg to stand on or how far to reach are left to the client. Poor judgment will adversely influence the performance and the scoring.
Equipment required for testing are a stop watch or watch with a second hand, and a ruler or other indicator of 2, 4, and 10 inches (5, 12, 25 cm). Chairs used during testing should be of reasonable height. Either a step or stool (average step height) may be used for item #12.
At the end of the test sum up the scores of the 14 items. Scoring is on a scale of 0-56. The Norms (CDE) for 60-69 years: 55, 70-79 years: 53-54, and 80-89 years: 53-50. A score of >45 is at lower risk for falls. Score 56-54: 1 point drop = 3 to 4% increase in fall risk; 54-46: 1 point drop = 6-8% increase; 40-45 cutoff for safety; 21-40 moderate fall risk; 0-20 high fall risk; below 36 = Risk for falls is close to 100%. The pediatric balance scale has no norms, other than children age 7 should achieve max of 56.
Age ranges of test Pediatric Balance Scale (age 5-15 yr), Berg Balance Scale 18-64 years; Elderly adult: 65+
Differences between pediatric and adult test procedures? The pediatric balance test is the version used in children, with modifications in some of the 14 items to have a better assessment of functional activities for children aged 5-15 years old with mild to moderate motor impairment. The test is administered in a different order and the time able to balance in different tasks for the scoring process is generally less in pediatrics. (ex. standing unsupported in adults for full 4 points is 2 minutes, and for pediatrics is 30 seconds.
Functional Reach
Test construct (What does it measure?) Assesses balance vestibular, balance on-vestibular, functional mobility, vestibular
General info about the test (may include brief scoring summary)
A practie trial may be given, a client wears no shoes or socks and the administrator positions a yardstick at the heigh of the acromion. Client stands comfortably (feet shoulder width apart) and extend the dominant arm/hand in front of the shoulder at shoulder height (palm facing down and hand fisted). The location of the 3rd metacarpal along the yardstick is recorded. Now one reaches forward as far as possible without loosing balance, taking a step, lifting heels up, or touching the wall/yardstick, then stop reaching. Subtract end position from the starting position to obtain the number of inches “reached”. Pause before the next reach and perform 3 trials and take the average of the trials. The age norms for the test are below.
3 year old 11.4 cm (Men and women)
4 year old 13.6 cm (Men and Women)
5 year old 15.7 cm (Men and women)
20-40 years (N = 44) 16.7 ± 1.9 inches (men) 14.6 ± 2.2 inches (women)
41-69 years ( N =50) 14.9 ± 2.2 inches (men) 13.8 ±2.2 inches (women)
70-87 years (N = 34) 13.2 ± 1.6 inches (men) 10.5 ± 3.5 inches (women)
Age ranges of test 3-15 year old children with caution in 3 year olds. Adult: 18-64 years; elderly adult: 65+
Differences between pediatric and adult test procedures?
