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Term 4 > Neuromuscular 2 Unit 2 > Flashcards

Neuromuscular 2 Unit 2 Flashcards

1
Q

What are some variables to consider when chooseing an Outcome Measure Test?

A
  • Dimensions (the focus of the measure according to the ICF model, like activity, participation, etc.)
  • Format (Performance based or conducted via self-reports)
  • Reliability
  • Validity
  • Responsiveness (detects change)
  • Feasibility
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2
Q

What are different Outcome Measure used to assess Balance?

A
  • Romberg
  • Sharpened Romberg
  • BERG Balance Scale
  • Tinetti Performance-Oriented Mobility Assessment
  • Functionl Reach
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3
Q

Balance Measure

With the Romberg OM, what does it assess and what ICF category does it test?

A
  • Static standing balance assessment
  • ICF: Body Structure and Function

Lacks reliability and validity

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4
Q

Balance Measure

With the Sharpened Romberg OM, what does it assess and what ICF category does it test?

A
  • Static standing balance - Tandem Stance
  • ICF: Body Structure and Function

Lacks reliability and validity

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5
Q

Balance Measure

With the BERG Balance Scale, what does it assess? How many task are there? What score indicates fall risk? What ICF category does it test?

A
  • Static/Dynamic standing balance/Functional mobility
  • There are 14 task each with a rated score from 1-4 for a total of 56 points
    (The lower the score = Decreased balance)
  • < 45 = functional (lower has been associated with fall risk)
  • ICF: Activity

Excellent Test-Retest and inter/intra rater reliability

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6
Q

Balance Measure

With the Tinetti Performance Assessment OM, what does it assess? How many items are there? What score indicates fall risk? What ICF category does it test?

A
  • Static/Dynamic balance/Gait Screen
  • 2 categories: Balance (9 items) and Gait (7 Items)
  • < 19 = Fall risk
  • ICF: Activity

Excellent reliability for most neuro diagnosis

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7
Q

Balance Measure

With the Functional Reach OM, what does it assess? With what conditions is it recommended for? What ICF categoty does it Test?

A
  • Quick standing balance screen
  • Maximum distance reached while in static position
  • Modified for sitting
  • Highly recommended for use in Stroke and PD; Recommended for MS
  • ICF: Activity

Excellent reliability

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8
Q

What are some different Outcome Measure that assess Balance and Gait Measures?

A
  • Timed Up and GO Test (TUG)
  • Timed Walking Test (6 minute Walk and 10 Meter walk)
  • Dynamic Gait Index (DGI)/Functional Gait Assessment (FGA)
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9
Q

With the Timed Up and GO Test (TUG), what does it assess? With what conditions is it recommened? What score indicated Fall risk? What ICF category does it Test?

A
  • Quick screen of dynamic balance and mobility in elderly
  • Highly recommended for elderly, PD and MS
  • Community dwelling adults: >13.5 seconds = fall risk
  • Frail elderly: >32.6 seconds = fall risk
  • ICF: Activity
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10
Q

With the 6 Minute Walk Test, what does it assess? With what conditions is it recommended? What ICF category does it test?

A
  • Measures functional endurance/ Activity tolerance
  • Highly recommended for most neurological diagnosis
  • ICF: Activity

Excellent Reliability

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11
Q

With the 10 Meter Walk Test, what ICF category does it test?

A
  • ICF: Activity
  • AD may be used
  • Assist may be given
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12
Q

With the DGI and FGA, what does it assess? What ICF category does it test?

A
  • Assesses higher level functional mobility
  • ICF: Activity
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13
Q

What is the Functional Independence Measure (FIM)?

Why is it important?

A

A common outcome measure used in the Acute rehab setting
- Assesses caregiver burden with “levels” associated with specific tasks (18 different)
- Commonly used at evaluation, re-evaluation (at least weekly) and discharge
- At discharge, will determine overall functional improvement

Importance:
- Effect in POC
- Effect on reimbursement
- Effect on length of stay

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14
Q

What are the Items rates with the Functional Independence Measure?

A
  • Self care
  • Sphincter control
  • Transfers
  • Locomotion
  • Communication
  • Social Cognition
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15
Q

FIM: Items rated

With the Safe Care aspect of FIM, what items are looked at?

A
  • Eating
  • Bathing
  • Dressing (upper)
  • Dressing (Lower)
  • Toileting
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16
Q

FIM: Items Rated

WIth the Sphincter Control aspect of FIM, what items are looked at?

A
  • Bladder
  • Bowel
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17
Q

FIM: Items Rated

With the Transfer aspect of FIM, what items are looked at?

A
  • Bed, chair, Wheelchair
  • Toliet
  • Tub, Shower
18
Q

FIM: Items Rated

With the Locomotion aspect of FIM, what items are looked at?

A
  • Walk / Wheelchair
  • Stairs
19
Q

FIM: Items Rated

With the Communication aspect of FIM, what items are looked at?

A
  • Comprehension
  • Expression
20
Q

FIM: Items Rated

With the Social Cognition aspect of FIM, what items are looked at?/

A
  • Social interaction
  • Problem solving
  • Memory
21
Q

When scoring FIM, what does a 7 mean?

A

Complete independence (No assistance, no DME, no extra time needed)

DME = Durable Medical Equipment

22
Q

When scoring FIM, what does a 6 mean?

A

Modified Independence (Use of AD, requires extra time)

23
Q

When scoring FIM, what does a 5 mean?

A

Supervision (Verbal cues or supervision for safety is required)

24
Q

When scoring FIM, what does a 4 mean?

A

Minimal Assistance (25% assistance required. Patient able to perform at least 75%)

Contact Guard Assist (CGA) and Stand By Assist (SBA) fall iin this category as well

25
Q

When scoring FIM, what does a 3 mean?

A

Moderate Assistance (50% assistance required. Patient able to perform at least 50%)

26
Q

When scoring FIM, what does a 2 mean?

A

Maximum Assistance (50-75% assistance required. Patient able to perform at least 25%)

27
Q

When scoring FIM, what does a 1 mean?

A

Total Assistance (>75% is required, or use of >1 person)

28
Q

When scoring FIM, what does a 0 mean?

A

Task does not occur

29
Q

What is the CARE Tool Set?

A
  • This facilitates consistency in scoring patients across the continuum of care from Acute care to Post Acute Care

Has replaced FIM in Acute Care
- Its similar to the FIM, it assesses caregiver burden with “levels” associated with specific task (however its more detailed than the FIM)
- Similar to FIM, Commonly used at evaluation, re-evaluation (at least weekly) and discharge
- At discharge, will determine overall functional improvement

30
Q

What are some Updated Items that the CARE Tool Set has compared to FIM?

A
  • Differentiates supine to sit, sit to stand and Bed to chair transfer
  • Ability to step over a curb or up/down one step
  • Walk 50’ with 2 turns
  • Stairs broken down: (1) 12 steps (2) 4 steps
  • Walking 10’ on uneven surface
  • Car transfer
  • Wheelchair propulsion with short or long ramp
  • Endurance Assessment
    –Capacity to walk or propel wheelchair 50’
    –Able to tolerate sitting for 15 min
31
Q

When scoring, CARE Tool Set, what is a 6?

A

Independent: Patient completes the activity by him/herself with no assistance from a helper

32
Q

When scoring, CARE Tool Set, what is a 5?

A

Setup or Clean-up assistance: Helper SETS UP or CLEANS UP; patient completes activity. Helper assists only prior to or following the activity

33
Q

When scoring, CARE Tool Set, what is a 4?

A

Supervision or Touching Assistance: Helper provides VERBAL CUES or TOUCHING/STEADYING assistance as patient completes activity. Assistance may be provided throughtout the activity or intermittently

34
Q

When scoring, CARE Tool Set, what is a 3?

A

Partial/Moderate Assistance: Helper does LESS THAN HALF the effort. Helper lifts, holds or supports trunk or limbs, but provides more than half the effort

35
Q

When scoring, CARE Tool Set, what is a 2?

A

Substantial/Maximal Assistance: Helper does MORE THAN HALF the effort. Helper lifts or hold trunk or limbs and provides more than half the effort

36
Q

When scoring, CARE Tool Set, what is a 1?

A

Dependent: Helper does ALL the effort. Patient does none of the effort to complete the task

37
Q

When scoring, CARE Tool Set, what is a M?

A

Not Attempted due to Medical Condition

38
Q

When scoring, CARE Tool Set, what is a S?

A

Not Attempted due to Safety concerns

39
Q

When scoring, CARE Tool Set, what is a A?

A

Task Attempted due to Safety concerns

40
Q

When scoring, CARE Tool Set, what is a N?

A

Not Applicable

41
Q

When scoring, CARE Tool Set, what is a P?

A

Patient Refused

Term 4 (14 decks)

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