Outcome measure flashcards
What are the highly recommended outcome measures in the acute stage for CVA?
- Orpington prognostic scale
- 6MWT
- 10MWT
- Functional Reach
- PASS
- TUG
What are the highly recommended outcome measures in the IP and OP rehab setting for CVA?
6MWT 10MWT Functional Reach PASS TUG FIM (IP only) Goal Attainment Scale Motor Activity log (upper limb performance) Stroke Impact Scale (OP only)
Describe the categories for the NIH Stroke Scale
Recommended at all stages and levels of care (grade severity of stroke) 0-42 points total 1-5- Mild 5-14-Moderate 15-24-Severe >25- very severe
What are the prognostic values for the Orpington Prognostic Scale?
3.2.-5.2= respond better to rehab <3.2= DC home >5.2= institutionalized
Acute care setting only!
What score on the Cherokee McMaster Stroke Assessment is indicative of individual being able to ambulate INDEP?
> 9 on the postural control and leg scores
Higher scores are better
1 is flaccid and 7 is normal movement
-Out of 100; higher score is better
What is a typical hand grip strength for normal men/women?
100# for men, 65# for women
How is the Tinetti Falls Efficacy Scale rated?
On a scale from 1-10, 1 very confident and 10 not confident, rate doing following activities without falling
Activity, participation, self reported measure for rating balance confidence
> 70 points- fear of falling
80 points- risk for falling
Fugyl-Meyer Score
10-25- no fine motor skills required
25-45- working on grasp/release
45-56- work on fine motor skills
(make sure this card is correct)
Modified Rankin Scale
Looks at assistance level required for self care, ADLs, and overall function
- Self report, observation measure
- 0-5 (0 no symptoms, 5 bed ridden)
Time to achieve INDEP level
Score of 3= 96 days
(make sure this card is correct)
What area of the ICF does the Modified Rankin Scale measure?
Participation
Barthel Index
Shows individual’s ability to care for self
10 ADL items rated based on level of assist the P requires
0-100
Higher the better
Lower admission score= greater change in score at DC
43.7/80.5
Functional Ambulation Categories (CVA)
Range from 0 (non functional) to 6 (independent)
Activity level measure
What is the average score on Trunk Impairment Scale for non-ambulatory patients?
8
Average score for ambulatory patients is 14
Looks at static sitting balance, dynamic sitting balance, and coordination
Range from 0-23 (higher score better)
Modified Ashworth Scale Grading Criteria
0- no increase in muscle tone
1- Catch and release at end of ROM
1+- Catch and minimal resistance through < 1/2 of ROM
2- Increased resistance through most of the ROM, affected parts easily moved
3- Passive movement difficult
4-Affected parts rigid in flexion or extension
Does the MAS have high reliability or validity in CVA?
NOPE
What are the cutoff gait speeds for household vs community ambulators?
<0.4 m/sec- household amb
0.4-0.8 m/sec- limited community
>0.8 m/sec- community
>1.2 m/sec- crossing streets and normal walking speed
<1.0 m/sec- need assistance
<0.6 m/sec- DEP in ADLs, more likely to be hospitalized
>1.0 m/sec- INDEP in ADLs, less likely to be hospitalized
What are the 10MWT normative values for self-selected gait speed?
1.2-1.4 m/sec?
What score on the BBS indicates greater likelihood of DC to home?
20/56
Functional Reach cutoff score for fall risk
<6’’ or 15 cm
Activity level measure
Postural Assessment Scale for Stroke (PASS)
Able to predict functional ability and DC destination better than trunk impairment scale
-Activity and BSF level
12 items
0-36 higher score is better
>12.5 ambulatory at DC
What cutoff time on the TUG indicates increased risk for falls in CVA?
14 sec
What cutoff time on the TUG indicates increased risk for falls in community dwelling adults?
13.5 sec
Activity Specific Balance Confidence Scale cutoff score for risk in elderly adults
67%
Higher scores indicate increased confidence in one’s balance
What is the ABC cutoff score for falls risk in patients with chronic stroke?
81%
What is a FIM score of 80-96 predictive of?
DC home
What range of FIM scores demonstrates higher gains with rehab?
37-72
Lowest score is 18, highest score is 126
Dynamic gait index cutoff score for fall risk (CVA)
<19
5x STS cutoff score for fall risk in CVA population
> 12 sec
5xSTS cutoff score for fall risk in PD population
> 16 sec
Floor effect in PD b/c patients can’t stand w/ UEs
What is the key difference between the FIM and the Wolf Motor Function test?
Wolf Motor Function test takes into account quality of UE movement
Looks at use of the paretic UE in functional tasks
Scores range from 0-75, higher scores is better functioning
What is the normative values for 9 hole peg test?
20-30s- 17 sec 30s-40s- 18 sec 40-50s- 19 sec 50-60s-19- 21 sec 60-70s-21-22 sec >75- 25 sec
What walking speed categories INDEP in ADLs?
> 1.0 m/sec
What walking speed categorizes more likely to DC home?
> 0.15 m/sec
What are the STREAM score categories for DC home?
Score of
<63- 0% DC home
63-95- 55% DC home
95-100- 86% DC home
Evaluation of motor function post stroke
What are Mini Mental State Exam Categories?
<24 cut off score
None 24-30
Mild 18-24
Severe 0-17
What is the Motor Activity Log?
Self rating of quality and amount of hemiparetic arm use
Activity level
Used in IP and OP rehab setting only
30 daily functional tasks
6 pt ordinal scale
0- not used at all
5-uses normally
Higher score=better quality of movement
out of 180 points?
What is the Action Research Arm Test?
Provides more information on grasp, grip, and pinch
Activity level measure
19 items out of 57 points 0-cannot perform 3-Normal Higher score=better functioning
What is the SIP-30?
Sickness Impact Profile Assesses perceived health status Self report 0-100% Higher score= worse health status
What are the highly recommended outcome measures or AIS A/B?
- ASIA impairment scale
- World Health Organization Quality of Life-BREF
**Higher score better QOL (out of 130 points?)
5- best score
26 items?
What are the highly recommended outcome measures for AIS C/D?
- ASIA impairment scale
- 6MWT
- 10MWT
- TUG
- Walking Index for SCI II (WISCI II, not >6 months)
WISCI II
0- Unable
5- Parallel bars, braces, no assist, 10 m
8- walker, no braces, 1 person assist, 10 m
10- one cane/crutch, braces, 1 person assist, 10 m
13- walker, no braces, no assist, 10 m
15- one cane/crutch, no brace, 1 person assist
17- no device, no braces, 1 person assist
20- no device, no braces, no assist
What stage post injury is the Walking Index for SCI II recommended?
Acute <3 months
What stage post injury is the World Health Organization Quality of Life-BREF recommended?
Chronic >6 months
Activity/participation level measure
What muscle strength in the quads indicates use of KAFO vs AFO?
<3= KAFO >3= AFO
What are the mean TUG times for paraplegia and tetraplegia?
Paraplegia- 20 sec
Tetraplegia- 15 sec
How is the WISCI II scored?
Score 0-20
0= unable to stand/participate in walking
20= amb with no AD or assist
Less responsive for higher functioning individuals
Gives more information on bracing and ADs
Activity level measure
What is the SCIM?
Spinal cord independence measure
Similar to FIM
Out of 100 points
Activity level measure
What is the SCI FAI
SCI Functional Ambulation Inventory
Looks at 3 domains of walking function
- gait parameters
- Assistive device
- Temporal distance
Activity level measure
0-39
Higher score=higher level of function
What is the WUSPI?
Wheelchair users shoulder pain index
Score ranges 0-150
15 items
higher scores=greater pain
What does a high score on the WUSPI indicate?
Increased shoulder pain with activity
What MMT scores indicate use of specific strength testing measures?
> 3/5 use handheld myometry
<2+/5, use MMT
What time period post injury has the 6MWT shown the greatest responsiveness?
3-6 months post injury
What are the highly recommended outcome measures in the acute care setting for TBI?
Coma Recovery Scale
Agitated Behavior Scale
Rancho Levels of Cognitive Functioning
Moss Attention Rating Scale
What are the highly recommended outcome measures in the inpatient setting for TBI?
CRS
MARS
What are the highly recommended outcome measures in the outpatient setting according to TBIEDGE task force?
6MWT
Functional Assessment Measure
Based on the Coma Recovery Scale, what indicates emergence from minimally conscious state? CRS is also known as the JFK Coma Scale
Motor score of 6 or communication score of 2
Can help distinguish vegetative and minimally conscious state as well as determine emergence from minimally conscious state
What Rancho Levels is the CRS appropriate for?
Rancho levels I-IV
What is the range of scores on the CRS?
0-23
Lower scores= reflexive and brainstem level activity