Outcome Measures Flashcards
Functional Gait Assessment cutoff
- cutoff: 22/30, fall risk
- postural stability during walking
- balance, gait, fall risk
Falls Efficacy Scale
- self-administered questionnaire to assess fear of falling in community dwelling older adults
- 10-100
- 70 cutoff for fear of falling
ABC
Cutoff for fall risk for chronic stroke:
Cutoff for elderly adults:
81%
67%
9 hole peg test
Age: Mean time (secs): 21-35 16-18 36-50: 17-19 51-65: 18-21 66-older: 21-25
Females slightly faster than male norms
Gait speed norms based on age
20s: 1.39/1.41 (m/f)
30s: 1.46/1.42
40: 1.46/1.39
50s: 1.39/ 1.40
60s: 1.36/1.30
70s: 1.33/1.27
Orpington Prognostic Scale
-excellent validity for prognostic factors in acute stroke
<3.2 = high likelihood for returning home
4.2 - 5.2 = respond better to rehab
> 5.2 = dependent with increased risk for institutionalization
FIM norms
- may assist to determine expected small or large gains while in inpatient rehab
- scores of 37 to 72 at admission showed higher gains than patients who scored > 73 or < 36
- 18-126
National Institute of health stroke scale (NIHSS)
Measures severity of stroke
Very severe: > 25
Severe: 15-24
Mild to moderate: 5-14
Mild: 1-5
Walking speed (picture)
Dependent with ADLs/IADLS & more likely to be hospitalized
Need intervention to reduce risk for falls
D/C to SNF
Less likely to have adverse event
Independent in ADLs/ less likely to be hospitalized
D/c to home more likely
Household walker
Limited community
Community
Cross street
0- 0.6 m/s
0- 1.0 m/s
0- 0.1 m/s
- 0-1.4 m/s
- 0- 1.4 m/s
- 1- 1.4 m/s
Household: 0- 0.3 m/s
Limited community: 0.3- 0.8 m/s
Community: 0.8- 1.2 m/s (greater then 0.8 is cutoff for community)
Cross street: 1.24- 1.4 m/s
Mini mental state level of impairment
- monitoring memory deterioration over time
None: 24-30
Mild: 18-24
Severe: 0-17
Berg Balance Scale
Score interpretation
MDC for
Stroke
PD
Huntington’s
0-20: wheelchair bound
21-40: assistance with walking
41-56: independent
Cutoff for elderly: 45/56
- 39= 100% risk for falls
Acute stroke: 6-7 points
Chronic stroke: 4.6-6.7 points
PD: 5 points - no fall cutoffs for PD
HD:
(Premanifest): 1 point
(Early stage): 4 points
(Middle-late): 5 points
Berg Balance Cutoff score
Non specific / Older Adult
= 40 : almost 100% fall risk
= 50 : fall risk
10 meter walk test
MCD for CVA
0.16 m/s
(Look for change from one category to be next) ex: household ambulator to community ambulator
Berg Balance Cutoff score
Non specific / Older Adult
= 40 : almost 100% fall risk
= 50 : fall risk
Timed Up and Go
Risk for fall score
Community dwelling adults
Bilateral vestibular disorders
Variety of vestibular disorders
> 13.5 seconds : community adults
> 14: older pts with stroke
> 15: older pts already attending a falls clinic
> 19: LE amputees
> 11.5-7.9 : Parkinson’s
> 10: hip OA
> 11.1 seconds: vestibular disorders
- difference b/w tug and tug manual over 4.5 secs = greater risk for falls in okder adults
- b/w tug and tug cog over 15 seconds = greater risk for falls in older adults
- high diagnostic accuracy of predicting shunt effectiveness in patients with NPH (vs 10MWT), 5 seconds from pre to post tap
Four square step test
Fall risk cutoff
Community dwelling
Vestibular disorders
15 seconds: community
12 seconds: vestibular
Five Times Sit to Stand
High risk for falls cutoff score
Aged Norms
- for LE strength and endurance ***
More than 12 seconds: high risk for falls
Aged norms: 50-59: 7.1 seconds 60-69: 8.1 seconds 70-79: 10 seconds 80-89: 10.6 seconds
Dynamic Gait Index
24 point scale
High risk cutoff score:
19 or below: high fall risk (community dwelling elderly and vestibular)
< 12 for MS
MCID: 1.8 for CDA
Tinetti Mobility Scale
- measure of gait and balance
Gait: max score = 12
Balance: max score = 16
Total= 28
Below 19= high risk for falls
ALS functional rating scale - revised
Max score
Cutoffs
48= max score
Cutoffs: 41/48 mild ADL and mobility deficits
28/48= moderate disability (middle stage)
10/48 = severe disability (late stages)
Moss Attention Rating Scale
- restlessness/distractibility, initiation, sustained attention
- valid for TBI, not valid for nTBI
- predictor of disability 1 year after TBI
- Ranchos level 4-5
- 5 point likert scale
- observations you made over the past 2 days
22-110
- higher = poorer attention
1= definitely false 2 = false, for the most part 3=sometimes true, sometimes false 4= true, for the most part 5=definitely true
Burke Lateropulsion Scale
- pushing scale
0-17 (resistance scale)
- higher = worse (add an extra point if resistance to both sides)
- supine, sitting, standing, transfers, walking
> /= 2 : pushing cutoff
> /= 11 : impaired safety in sitting
Hoehn and Yahr Scale for PD
Stage 1: unilateral involvement only, minimal to no functional disability
Stage 1.5 (modified): unilateral and axial involvement
Stage 2: bilateral or midline involvement without impairment of balance
Stage 2.5 (modified): mild bilateral disease with recovery of pull test
Stage 3: bilateral, mild to moderate disability with impaired postural reflexes, physically independent (same as modified)
Stage 4: severely disabling, able to stand or walk unassisted (same as modified)
Stage 5: confinement to bed or wheelchair unless aided (same as modified)
6 meter walk test
Community dwelling adults
60-69:
70-79:
80-89:
60-69: 538-572m
70-79: 471-527m
80-89: 392-417
MIP and MEP
Percentage of norms for significant pulmonary muscle weakness
MIP: 50-77% of predicted norms
MEP: 34-60% of predicted norms
Box and block test norms
40s: 83-78 blocks in 1 minute
50s: 73-79
60s: 72-71
70s +: 63-66
To detect non organic paresis in LE
- resisting abduction in paretic LE, sound LE remains fixed - organic paresis
- resisting abduction in paretic LE, causes sound limb to hyperadduct in non-organic
Hoovers sign (to assess non organic weakness)
- supine SLR with downward pressure on paretic side and upward pressure under uninvolved side with either:
- paretic leg exerts full downward pressure when non paretic is raised
- OR uninvolved side exerts weak downward pressure or can be lifted by examiner when paretic side is raised
Tardieu Scale measures
Muscle tone and hyperreflexia (body structures/function)
Push and release test measures
Stepping strategy (activity/movement strategy)
TASK characteristics
Stability, transitions, mobility, manipulation, concurrent tasks
SLUMS screening for dementia
20 or below = dementia
21- 26 = mild cog disorder
Walking while talking test cutoffs
Dementia
20 seconds: simple
30 seconds: complex
Dizziness Handicap inventory
Excellent reliability and validity for peripheral vestibular disorders
Expanded Disability Status Scale (EDSS)
For MS
0-3.5 = normal to mild disability 4- 5.5 = mild to moderate disability 6-7.5 = moderate to severe 8-9.5 = severe disability with restriction to bed or wheelchair 10 = death
30 second chair to stand cutoff
< 8-13 reps = increased fall risk
Global deterioration scale (dementia)
1-7
1- no cognitive decline 2- very mild decline (age related) 3- mild cog decline 4- mild dementia (new learning) 5- moderate dementia 6- moderately severe dementia 7- Severe dementia
SARA: scale for assessment and rating of ataxia
0-40
40= severe
Mini Best test cutoff
PD: 20/32 - to identify fallers
