Outcome Measures- Master Flashcards
Five times sit to stand
-cerebellar dysfunction, cerebral palsy, geriatrics, PD, stroke, vestibular
-functional LE strength
-activity limitation
>13 seconds is balance dysfunction
MCID 2.3 sec
6-minute walk test
- stroke, TBI, PD, pulmonary/cardiac disease, elderly individuals, healthy individuals
- activity limitation
- Borg RPE can be used
- no cut-offs
- note assistance with ambulation and AD
9-hole peg test
- acquired brain injury, stroke, MS
- timed test to measure finger dexterity
- body structure/function and activity limitation
- no cut-offs, but norms for ages and populations
10-meter walk
- Alzheimer’s, brain tumor, children with neuromuscular diseases, community dwelling older adults, movement disorders, hip fracture, LE amputation, MS, PD, SCI, TBI, stroke, vestibular
- 3 trials, score average of 2nd and 3rd
- activity limitation
- household ambulation <0.4
- limited community 0.4-0.8
- community >0.8
- note assistance with ambulation and AD
12-item MS walking scale
- MS
- questionnaire designed to subjectively measure an individual’s ability to ambulated
- activity limitation
- 12-60 points, 20-100% is range
- higher number = greater disability
- no cut-offs
Activities-specific balance confidence scale
-MS, PD, stroke, vestibular, TBI
-subjective measure of confidence in walking tasks
-activity limitation and participation restriction
-0-100 score
-higher number = greater confidence
-most common cut-off is 67%, but varies based on population
MCID 10 points or over 80%
Agitated behavior scale
- TBI
- observation measure- includes distractibility, unpredictable anger, repetitive behaviors, self-abusiveness, etc during acute phase
- body structure/function and participation restriction
- score 14-56 (higher = more agitated)
- WNL <= 21
- mild 22-28
- moderate 29-35
- severe >35
Amyotrophic lateral sclerosis functional rating scale
- ALS
- subjective report on functional ability while living with ALS
- revised version includes new items to assess respiratory function
- activity limitation and participation restriction
- ALSFRS 0-40, revised 0-48
- higher score = better function
- no cut-offs
ASIA impairment scale
- SCI
- neurologic level of SCI
- body structure/function
Barthel index
-stroke, geriatrics, TBI
-rates performance of 10 ADL/mobility tasks
-activity limitation
-0-100
-higher score is greater independence
-scores indicating favorable outcomes in acute stroke:
—>95 with 85.6% sensitivity, 91.7% specificity
—>90 with 90.7 sens, 88.1 spec
—>75 with 95.7% sens, 88.5% spec
-activities include feeding, bathing, grooming, dressing, bowel control, bladder control, toileting, chair transfers, ambulation, stair climbing
Berg balance scale
-community dwelling elders, stroke
-activity limitation
-0-56 (higher is better)
<45 falls risk
Balance evaluation systems test (BESTest)
-geriatrics, PD, stroke, cerebellar dysfunction, vestibular, MS
-assess balance impairments across 6 systems- bio mechanical constraints, stability limits, anticipatory adjustments, postural responses, sensory organization, and stability in gait
-body structure/function, activity limitation
-max score 108 converted to percentage
-higher score is better function/balance
<69% fall risk
Chedoke-McMaster stroke assessment
-stroke, acquired brain injury
-assess presence and severity of physical impairments and amount of change in functional ability
-body structure/function
-0-100 (higher scores reflect normal function)
>9 on the leg and postural control scores indicates independent ambulation
Clinical test of sensory interaction and balance
- vestibular, community dwelling elderly, cerebellar dysfunction, general balance patients
- ability to maintain balance under various conditions challenging the somatosensory, visual, and vestibular systems
- body structure/function, activity limitation
- average time for each condition recorded, higher time better stability
- CTSIB is 6 conditions, modified is 4 conditions
- on CTSIB conditions 5 and 6 are vestibular; m-CTSIB condition 4
Coma recovery scale- revised
- TBI, brain tumor, TBI with CVA, hypoxic brain injury
- assists with differential diagnosis, prognostic assessment, and treatment planning in DOC
- body structure/function
- 0-23 (higher score is better functioning)
- no cut-offs
Community balance and mobility scale
- TBI, cerebral palsy, stroke, geriatric, acquired brain injury, healthy adults
- high level balance and mobility in community
- body structure/function, activity limitation
- 0-95 (higher score is greater ability)
- no cut-offs
- can use orthotic but not AD
Disability rating scale
- TBI and acquired brain injury
- observer-rated 30-point scale that determines function in consciousness, cognitive ability, dependence on others, and employability
- body structure/function, activity limitation, participation restriction
- 0-29 (LOWER score is greater ability)
Dizziness handicap inventory
-geriatrics, MS, TBI, vestibular
-scale to determine amount of limitation perceived due to effects of dizziness
-body structure/function, participation restriction
-0-100 (LOWER number is less handicap)
>59 increase risk for falls in MS
-for vestibular patients:
— mild perception of handicap 0-30
—moderate 31-60
—severe >= 61
MCID 18 pts
Dynamic gait index
-brain injury, geriatric, MS, PD, stroke, vestibular
-assess ability to maintain postural stability during various walking tasks
-activity limitation
-0-24 (higher score better functional ambulation)
<=19 is fall risk
DGI 3 pts or >20
Falls efficacy scale
- MS, PD, SCI, stroke, brain injury, geriatrics
- assess perception of balance and fear of falling during ADLs
- activity limitation, participation restriction
- 10-100 (LOWER score is greater confidence)
- no cut-off
- includes only household activities
Frenchay activities index
- stroke, geriatrics
- assess ability of patients to complete ADLs while recovering from stroke
- activity limitation, participation restriction
- 15-60 (higher score is higher level of activity)
- no cut-offs
Functional assessment scale
-stroke, TBI, MS, geriatrics
-12 items to add on to FIM to further target brain injury
-body structure/function, activity limitation, participation restriction
-12-84 (higher score is higher function)
<65 at risk for long term unemployment
-training required
Functional independence measure
- stroke, TBI, SCI, MS, elderly
- level of disability and amount of assistance required for ADLs with performance of 18 tasks
- activity limitation
- 18-126 (higher is higher function)
- no cut-offs
- training and certification required, used in IRF
Friedreich’s ataxia rating scale
- Freidreich’s ataxia
- assess ataxia and resulting impairment
- 0-159 (LOWER score is less disability)
- no cut-offs
Freezing of gait questionnaire
- PD
- subjectively assesses FOG
- activity limitation
- 0-24 (LOWER score is less freezing)
- no cuto-ffs
- to be completed during “on” state
Fugl-Meyer assessment scale
- stroke
- impairment and recovery in 5 domains including motor function, sensory function, balance, joint ROM, joint pain after stroke
- body structure/function
- 0-226 (higher score is improved function)
Functional gait assessment
-geriatrics, PD, stroke, vestibular
-assess balance during various walking tasks
-activity limitation
-0-30 (higher score more functional ambulation)
<23 is falls risk
-similar to DGI with addition of tandem walking, eyes closed, retro-walking
MCID 8 pts
Functional reach test
-community dwelling elderly, PD, peripheral vestibular disorders, SCI, stroke
-use 3rd metacarpals for reference
-activity limitation
<15 cm is falls risk
-many modifications included seated
Goal attainment scale
-acquired brain injury, CP, geriatrics, LE amputation, movement disorders, pain, PD, stroke, TBI, vestibular
-individualized goal selection of 1-6 goals rated on 5-point scale
-body structure/function, activity limitation, participation restriction
2+ more than expected
1+ somewhat more than expected
0 goal achieved
1- somewhat less than expected
2- much less than expected
-no cut-offs
-weight by importance and difficulty
Hand held myometry
- cerebral palsy, movement disorders, SCI, myopathics, neuropathics, elderly
- assess strength and finger and wrist musculature used with grip
- body structure/function
- no cut-offs
- compared strength of involved to uninvolved or to age-matched norms
High-level mobility assessment tool
-traumatic and acquired brain injury
-high level balance and mobility performance
-activity limitation
-0-54 (higher score is better performance)
-no cut-offs
-norms:
—males 18-25 y/o 50-54
—females 18-25 y/o 44-54
-orthotics allowed, must be able to ambulate independently over 20 meters without AD
International cooperative ataxia rating scale
- Freidreich’s ataxia, spinocerebellar disorders
- impairment as a result of hereditary ataxia with regard to postural and gait disturbance, limb ataxia, dysarthria, and oculomotor disorders
- activity limitation
- 0-100 (LOWER score is less impairment)
- no cut-offs
Mini-BESTest
-acquired/TBI, geriatrics, movement disorders, MS, PD, stroke, vestibular
-abbreviated 14-item scale using psychometric techniques to improve BESTest
-body structure/function, activity limitation
-0-28 (higher score is less impairment)
<23 is fall risk
Mini mental state exam
-stroke, TBI, geriatrics
-screening tool using several questions and tasks to assess cognitive impairment
-body structure/function
-0-30 (higher score is better cognition)
<24 is cognitive impairment
Modified Ashworth scale
- CNS impairment
- measures spasticity
- body structure/function
- 0-4 (higher more spasticity
- no cut-offs
Modified falls efficacy scale
-geriatrics
-perception of balance and fear of falling during ADLs
-activity limitation and participation restriction
-0-10 (higher score is more confidence)
<4 predictive of falls and longer hospital stay
-confidence in performing 14 indoor and outdoor tasks rated 0-10. Final score is average (total score/ items rated)
Modified fatigue impact scale
- MS
- determines effects of fatigue involving physical, cognitive, and psychosocial aspects of daily life
- body structure/function, activity limitation
- 0-84 (LOWER number is less impact of fatigue)
- no cut-offs
Montreal cognitive assessment
-geriatrics, PD, stroke, dementia
-screening tool to detect mild cognitive dysfunction
-body structure/function
-0-30 (higher score is better cognition)
<26 suggests cognitive dysfunction
Involves executive function and memory tasks, good for vascular dementia and vascular cognitive impairment
Moss attention rating scale
- TBI
- observational tool to measure attention-related behaviors following TBI
- body structure/function
- 22-110 (higher score is better attention)
- no cut-offs
Motion sensitivity quotient
- vestibular dysfunction
- measures motion-provoked dizziness
- body structure/function, activity limitation
- calculation converts score 0-100% (LOWER score is less motion sensitivity)
- mild 0-10%
- moderate 11-30%
- severe 31-100%
Motor activity log
- stroke
- interview to asses arm function based on quality and amount of movement
- activity limitation, participation restriction
- total score based on variation of test used
- 0-5 (higher score is better function)
- no cut-offs
- variations include 14, 28, or 30 tasks
Motor assessment scale
- stroke
- ability to complete tasks completed during normal daily life
- activity limitation
- 0-48 (higher score better motor function)
- no cut-offs
MS functional composite
- MS
- evaluates cognition, gait, and UE function in MS
- body structure/function, activity limitation
- includes timed 25-foot walk, 9-hold peg test, and paced auditory serial addition test
- no cut-offs
MS impact scale
- MS
- questionnaire to measure physical and psychological impact of MS on daily life
- participation restriction
- 29-145 (LOWER scores decreased impact of MS on daily life)
- no cut-offs
MS quality of life
- MS
- QOL questionnaire focusing on physical health and mental health tailored to MS-specific issues
- activity limitation, participation restriction
- no overall score, summary scores for physical and mental health based on combination of scale scores
- no cut-offs
National institutes of health stroke scale
- stroke
- measures severity of symptoms and impairments following stroke
- body structure/function
- 0-42 (LOWER score is less severity
- mild 1-5
- mild to mod 5-14
- severe 15-24
- very severe >25
Numeric pain rating scale
- populations with pain, SCI
- subjective intensity of pain
- body structure/function
- 0-10 (LOWER score less pain)
- mild 1-3
- moderate 4-6
- severe 7-10
Orpington prognostic scale
- stroke including those with aphasia, dysarthria, and dementia
- four sub scales (motor deficit in arm, proprioception, balance and cognition) to determine stroke severity
- body structure/function
- 1.6-6.8 (LOWER score is less deficit)
- mild to mod <3.2
- mod to severe 3.2-5.2
- severe or major >5.2
Parkinson’s disease questionnaire-39
- PD
- questionnaire assessing PD-specific health-related QOL based on 8 dimensions (mobility, ADLs, emotional well-being, stigma, cognition, communication, bodily discomfort)
- participation restriction
- 0-156 (LOWER score better QOL)
- no cut-offs
Patient health questionnaire
-cardiology, dementia, general medical outpatients, oncology, PD, primary care, SCI, stroke, TBI
-self-report of depressive symptoms over previous 2 weeks
-body structure/function
-0-27 (higher score more depression)
>12 suggests major depressive disorder
Physical performance test
-PD
-assess ability to complete tasks representative of ADLs
-activity limitation
-0-36 (higher score better performance)
<17 unable to function in community
17-24 moderate frailty
25-32 mild frailty
32-36 not frail
-modified version with 7 items instead of 9
Postural assessment scale for stroke patients
- stroke
- assess and monitor postural ability in lying, sitting, and standing while maintaining or changing position in 12 tasks
- activity limitation
- 0-36 (higher score more able)
- no cut-offs
Push and release test
-cerebellar dysfunction, PD, vestibular, general balance patients
-assess instability by ability to regain balance
-body structure/function, activity limitation
-scored 0-4
0- recovers with 1 step independently
1- needs 2-3 steps to recover
2- 4+ steps required but independent
3- able to step but needs assistance
4- falls without attempting a step or unable to stand without assistance
-no cut-offs
Quality of life after brain injury
- TBI
- health-related QOL questionnaire
- participation restriction
- 0-100 (higher is greater QOL)
- no cut-offs
Rancho levels of cognitive functioning
- TBI
- behavioral and cognitive characteristics associated with various stages of recovery after TBI
- body structure/function
- levels 1-8 (reviewed has 10 levels)- higher is greater function
- no cut-offs
Retropulsive pull test
-cerebellar dysfunction, PD, general balance patients
-assess nonvestibular-related balance impairment
-body structure/function, activity limitation
-scored 0-4
0- recovers independently with 1-2 steps or ankle strategy
1- recovers independently with 3+ steps
2- requires assistance to prevent fall
3- very unstable, loses balance spontaneously
4- unable to stand without assistance
-no cut-offs
-usually used for PD as part of UPDRS
Scale for the assessment and rating of ataxia
-cerebellar dysfunction, stroke
-quantitative assessment of impairments related to cerebellar ataxia
-body structure/function, activity limitation
-0-40 (LOWER score less ataxia)
-gait
—<=8 independent
—<=11.5 quad cane
—<=12.25 walker
-ADLs
—<=5.5 independent
—<=10 min dependent
—<=14.25 mod dependent
—>=23 max dependent
Sensory organization test
- cerebellar dysfunction, general balance patients, vestibular
- computerized posturography using 3 balance systems (somatosensory, visual, vestibular)
- body structure/function, activity limitation
- average COG sway for each trial and condition, composite score and ratios obtained to quantify use of each system
- conditions 5 and 6 isolate vestibular input
Stroke impact scale
- stroke
- self-report on stroke impact in 8 areas- strength, hand function, ADL/IADL, mobility, communication, memory and thinking, emotion, and participation/role function
- activity limitation, participation restriction
- 0-100 (higher score less impact/impairment)
- no cut-offs
Timed 25 foot walk
- MS
- obtain quantitative measure of mobility and leg function
- activity limitation
- no cut-offs
- average of 2 timed trials
Timed up and go
-geriatrics, MS, PD, SCI, stroke, vestibular, LBP, arthritis, amputees
-mobility, balance, and fall risk
-3 meters
-activity limitation
>13.5 seconds is falls risk
>=14.5 fall risk for TUG manual or difference of 4.5 seconds between TUG and TUG manual
>=15 falls risk for TUG cognitive
Tinetti performance oriented mobility assessment
- stroke, PD, geriatrics
- balance and functional ambulation
- activity limitation
- total 0-28
- balance score 0-16
- gait score 0-12
- higher score is better independence
- 25-28 low fall risk
- 19-24 medium fall risk
- <19 high fall risk
United Parkinson disease rating scale
- PD
- comprehensive assessment to determine impact of diagnosis of PD on daily life
- body structure/function, activity limitation, participation restriction
- 0-260 (LOWER score decreased disease impact)
- no cut-offs
- motor portion most commonly used in PT practice
Walking index for SCI II
- SCI
- determines amount of physical assistance and reliance on ambulatory aids for walking following SCI-related paralysis
- activity limitation
- 0-20 (higher score less severe impairment)
- no cut-offs
World Health Organization quality of life- BREF
- dementia, geriatrics, PD, SCI, stroke, wheelchair users
- measures QOL based on culture, values, goals
- participation restriction
- max score 100 each domain (higher score better QOL)
- no cut-offs
- domains- physical health, psychological health, social relationships, environment
Four square step test
> 15 seconds is multiple falls risk for older adults
