Neuromuscular: Examination Tests and Measures

Question 1

Glasgow Coma Scale

Answer 1

• Relates to consciousness to three elements, eye opening, motor response, verbal response.
• Typically used to asses acute concussions/TBI.
• Score range 3-15
• Minor brain injury=13-15
• Moderate brain injury=9-12
• Severe Brain injury=1-8

Question 2

Coma Recovery Scale-Revised

Answer 2

• Examines multiple domains (auditory, visual, arousal, etc.)
• Includes brain stem reflexes (pupillary reflex, corneal reflex, eye movements etc.)
• Recommended for use in multiple rehab settings and patients with various conditions.

Question 3

Mini Mental State Exam

Answer 3

• Brief screening test for cognitive dysfunction
• Includes screening for orientation, registration, attention, calculation, recall, and language.
• Max score=30
• Mild cognitive impairment=21-24
• Moderate cognitive impairment=16-20
• Severe Impairment=15 or less
• Evidence based but SHOULD NOT be used as a stand alone tool for diagnosis of cognitive impairment.

Question 4

Rancho Los Amigos Levels of Cognitive Function

Answer 4

• Assess cognitive recovery following a TBI
• Eight Levels
• Level I=No response
• Level II=Generalized response
• Level III=Localized response
• Levels IV=Confused agitated response
• Level V=Confused inappropriate response
• Level VI=Confused appropriate response
• Level VII=Automatic appropriate response
• Level VIII=Purposeful and appropriate response
• Delineates emerging behaviors.

Question 5

Modified Ashworth Scale (MAS)

Answer 5

• Grading Spasticity
• Six Grades
• 0=no increase in muscle tone
• 1=Slight increase in muscle tone with minimal resistance at the end range of motion.
• 1+=Slight increase in muscle tone, minimal resistance through less than HALF of the ROM
• 2=Marked increase in muscle tone through MOST of the ROM affected part easily moved.
• 3=Considerable increase in muscle tone, passive movements difficult.
• 4=Affected part rigid in flexion and extension.

Question 6

Deep Tendon Reflex Scoring Scale (DTR)

Answer 6

• 0=Absent
• 1+=Toe change but no visible movement of extremities.
• 2+=Visible movement of extremities
• 3+=Exaggerated full movement of extremities
• 4+=Obligatory and sustained movement lasting more than 30 seconds.

Question 7

Berg Balance Scale (BBS)

Answer 7

• Assesses functional Balance
• Includes sitting and standing balance
• Max score=56
• Fall Risk Scores <45
• Fall risk increases 6-8% for every one point drop from scores between 54-46
• *Part of the APTA recommended outcome measures

Question 8

Activities Specific Balance Confidence Scale (ABC Scale)

Answer 8

• Examines confidence to perform 16 different daily activities.
• Scale is 0-100%
• Lower scores=less confidence
• Higher scores=more confidence
• *Part of the APTA recommended outcome measures

Question 9

Functional Gait Assessment (FGA)

Answer 9

• Examines dynamic balance while walking.
• Max score=30
• *Part of the APTA recommended outcome measures

Question 10

The 10 Meter Walk Test (10mWt)

Answer 10

• Measures gait speed for middle 6 meters and comfortable pace and fast pace.
• Reported as meters/sec
• *Part of the APTA recommended outcome measures

Question 11

Six Minute Walk Test (6mwt)

Answer 11

• Examines endurance and stance walked over 6 minutes
• Reported as distance in meters
• *Part of the APTA recommended outcome measures

Question 12

Five Times Sit to Stand

Answer 12

• Examines transfer capability
• Timed using stopwatch
• *Part of the APTA recommended outcome measures

Question 13

Timed Up and Go (TUG)

Answer 13

• Examines functional dynamic balance
• Normal intact adults=<10 seconds
• Frail elderly/disabled patients=11-20 seconds
• Increased Fall Risk= >20 seconds
• High Fall Risk= >30 seconds

Question 14

Functional Reach Test (FR)

Answer 14

• Examines maximal distance a person can reach forward beyond arm’s length while maintaining a fixed position in standing.
• Men 20-40=16.7
• Men 41-69=14.9
• Men 70-87=13.2
• Women 20-40=14.6
• Women 41-69=13.8
• Women 70-87=10.5
• Moderate fall risk=6-10
• High Fall Risk=6 or less

Question 15

Multidirectional Reach Test (MDRT)

Answer 15

• Examines maximal distance a person can reach in multiple directions.
• Backward above average= >7.6 inches
• Backward Below Average= < 1.6 inches
• Lateral Above Average= >9.4 inches
• Lateral Below Average= <3.8 inches

Question 16

The Balance Evaluation Systems Test (BESTest)

Answer 16

• Examines biomechanics constraints
• Stability Limits Vertically
• Transitions/anticipatory
• Reactive
• Sensory Integration
• Scoring involves various measures

Question 17

The Mini Balance Evaluation Systems Test (Mini BESTest)

Answer 17

• Shorter version of the BESTest

- Items are scored 0-2 with max scores of 28

Question 18

Performance Oriented Mobility Assessment (POMA)

Answer 18

• Examines balance
• Mac score=28
• Moderate Fall Risk=19-24
• High Fall Risk= <19

Question 19

High Level Mobility Assessment Tool (Hi-MAT)

Answer 19

• Examines high level balance and mobility problems
• Max score=54
• Items scored via time or distance on a 0-5 scale

Question 20

Short Physical Performance Battery (SPPB)

Answer 20

• Combination of balance and functional tasks
• Tests scored in terms of time to complete
• Lowest score=0
• Highest score=12

Question 21

Balance Efficacy Scale (BES)

Answer 21

• Examines level of self confidence when performing functional tasks encountered in daily life.
• 18 items scored 0-100%
• Total score is divided by 18 to yield a mean score

Question 22

Dynamic Gait Index (DGI)

Answer 22

• Examines dynamic gait
• Max score=24
• Safe ambulation=22
• Fall Risk= <19

Question 23

Fugyl Meyer Assessment of Physical Performance (FMA)

*Stroke

Answer 23

• Examines movements of UE, LE, balance, sensation, ROM, and pain.
• Scores range from 0-can not perform to 2 fully performed.

Question 24

Functional Independence Measure (FIM)

*Stroke

Answer 24

• Examines physical, psychological, and social functioning

- Contains 18 items.

Question 25

Functional Assessment Measure (FAM)

*Stroke

Answer 25

• Includes additional measures to the FIM including Community access, instrumental ADL, safety, employability, adjustment

Question 26

Stroke Impact Scale

*Strok

Answer 26

• Impacts how a stroke has impacted things like:
• Physical function
• Memory
• Thinking
• Changes in mood and emotions
• Communication abilities
• Typical Daily activities
• Participation in activities

Question 27

Postural Assessment Scale (PASS)

*Stroke

Answer 27

• Provides a standardized measure for postural control and balance in patients following a stroke.

Question 28

Community Balance and Mobility Scale

*TBI

Answer 28

• Examines high level balance and mobility deficits with community tasks
• 13 item scale

Question 29

Moss Attention Rating Scale

*TBI

Answer 29

• Examines cognition and attention

Question 30

Dizziness Handicap Inventory

*TBI

Answer 30

• Examines a persons perception of disability through the use of three sub scales physical, emotional, and functional.
• 25 item scale