Phys dys Flashcards
Measurement instrument for evaluating joint range of motion; accuracy is ensured through following standardized procedures including:
• client position
• positioning of the instrument
Goniometer
Normal range of motion for the cervical spine
Degrees of measurement include: • flexion: 0-45 • extension: 0-45 • lateral flexion: 0-45 • rotation: 0-60
Normal range of motion for the thoracic and lumbar spine
Degrees of measurement include: • flexion: 0-80 • extension: 0-30 • lateral flexion: 0-40 • rotation: 0-45
Normal range of motion for the shoulder
Degrees of measurement include: • flexion: 0-170 • extension: 0-60 • horizontal abduction: 0-40 • horizontal adduction: 0-130 • internal rotation: 0-70 • external rotation: 0-90
Normal range of motion for the elbow and forearm
Degrees of measurement include:
• flexion: 0 to 135-150
• supination: 0 to 80-90
• pronation: 0 to 80-90
Normal range of motion for the wrist
Degrees of measurement include: • flexion: 0-80 • extension: 0-70 • ulnar deviation: 0-30 • radial deviation: 0-20
Normal range of motion for the thumb
Degrees of measurement include:
• MP flexion: 0-90
• IP flexion: 0 to 80-90
• abduction: 0-50
Normal range of motion for fingers
Degrees of measurement include: • MP flexion: 0-90 • MP hyperextension: 0 to 15-45 • PIP flexion: 0-110 • DIP flexion: 0-80 • abduction: 0-25
Normal range of motion for the hip
Degrees of measurement include: • flexion: 0-120 • extension: 0-30 • abduction: 0-40 • adduction: 0-35 • internal rotation: 0-45 • external rotation: 0-45
Normal range of motion for the knee
Degree of measurement include:
• flexion: 0-135
Normal range of motion for the ankle and foot
Degrees of measurement include: • plantar flexion: 0-50 • dorsiflexion: 0-15 • inversion: 0-35 • eversion: 0-20
Structured approach to measure muscle strength and apply a muscle grade to the maximal effort put forth
Grading scale range: Zero (0/5) to Normal (5/5)
Manual muscle testing
Muscle grade assigned for:
• no active movement noted
• no muscle contraction observed or palpated
Muscle grade 0/5
Muscle grade assigned for:
• trace movement observed and palpated
• no active movement noted, but muscle contraction is observed or palpated
Muscle grade 1/5
Muscle grade assigned for:
• poor strength observed where movement is noted only in a gravity-minimized plane
Score may range from:
• ___ (-): able to initiate movement in gravity-minimized plane
• ___: incomplete ROM in gravity-minimized plane
• ___ (+): complete ROM in gravity-minimized plane
Muscle grade 2/5
Muscle grade assigned for:
• fair strength observed where movement is noted against gravity
Score may range from:
• ___(-): incomplete ROM against gravity
• ___: full ROM against gravity with no resistance applied
• ___(+): full ROM against gravity and slight resistance
Muscle grade 3/5
Muscle grade assigned for:
• good strength observed with full ROM against gravity and moderate resistance
Muscle Grade 4/5
Muscle grade assigned for:
• normal strength observed with full ROM against gravity and maximal resistance
Muscle grade 5/5
Level of assistance where a client needs >75% verbal or physical assistance to complete a task or is unable to perform any component of the task
Dependent
Level of assistance where a client needs 50-75% verbal or physical assistance to complete a task
Maximal assistance
Level of assistance where a client needs 25-50% verbal or physical assistance to complete a task
Moderate assistance
Level of assistance where a client needs <25% verbal or physical assistance to complete a task
Minimal assistance
Level of assistance where a client requires caregiver or practitioner assistance to be within arm’s reach to safely complete a task
Stand-by assistance
Level of assistance where a client requires zero physical or verbal assistance to safely complete a task
Independent
Level of assistance where a client requires occasional verbal assistance to safely complete a task
Supervised
Level of assistance where a client requires use of adaptive equipment or increased time to complete a task
Modified independence
American Spinal Cord Injury Association neurological classification system used to determine level of impairment to the spinal cord after an injury.
Results are based on:
• sensory testing of each dermatome for right and left sides
• manual muscle testing for right and left sides
ASIA impairment scale (AIS)
Neurological classification for the level of impairment to the spinal cord after injury, characterized by:
• complete lesion with no motor or sensory function preserved in the sacral segments S4-S5
ASIA impairment scale (AIS A)
Neurological classification for the level of impairment to the spinal cord after injury, characterized by:
• incomplete lesion with sensory but no motor function preserved below the neurological level; includes the sacral segments S4-S5
ASIA impairment scale (AIS B)
Neurological classification for the level of impairment to the spinal cord after injury, characterized by:
• incomplete lesion with motor function preserved below the neurological level
• more than half of key muscles below the neurological level have a muscle grade less than 3 (fair)
ASIA impairment scale (AIS C)
Neurological classification for the level of impairment to the spinal cord after injury, characterized by:
• incomplete lesion with motor function preserved below the neurological level
• at least half of key muscles below the neurological level have a muscle grade of 3 (fair) or more strength
ASIA impairment scale (AIS D)
Neurological classification for the level of impairment to the spinal cord after injury, characterized by:
• normal motor and sensory function
ASIA impairment scale (AIS E)
Classification for this level of recovery after a traumatic brain injury:
No response: Total assistance
Characterized by:
• No change in behavior when presented with any form of stimuli
Rancho Los Amigos Level of Cognitive
Functioning: Level I
Classification for this level of recovery after a traumatic brain injury:
Generalized response: Total assistance
Characterized by:
• generalized reflex response to painful stimuli
• responses may be delayed
• responds to repeated auditory stimuli with increased or decreased activity
Rancho Los Amigos Level of Cognitive
Functioning: Level II
Classification for this level of recovery after a traumatic brain injury:
Localized response: Total assistance
Characterized by:
• response to discomfort by pulling tubes or drains
• blinks when bright light crosses visual field
• inconsistent response to simple commands
Rancho Los Amigos Level of Cognitive
Functioning: Level III
Classification for this level of recovery after a traumatic brain injury:
Confused/agitated: Maximal assistance
Characterized by:
• alert and in a heightened state of activity
• absent short-term memory
• purposeful attempt to remove restraints or tubes
• may exhibit aggressive behavior
Rancho Los Amigos Level of Cognitive
Functioning: Level IV
Classification for this level of recovery after a traumatic brain injury:
Confused, inappropriate nonagitated: Maximal assistance
Characterized by:
• not oriented to person, place, or time
• may wander
• unable to learn new information
• inappropriate use of objects without redirection
Rancho Los Amigos Level of Cognitive
Functioning: Level V
Classification for this level of recovery after a traumatic brain injury:
Confused, appropriate: Moderate assistance
Characterized by:
• inconsistent orientation to person, place, and time
• supervision needed for old learning (e.g. self-care tasks)
• may attend to a familiar task in a distraction-free environment for up to 30 minutes with moderate redirection
Rancho Los Amigos Level of Cognitive
Functioning: Level VI
Classification for this level of recovery after a traumatic brain injury:
Automatic, appropriate: Minimal assistance for daily living skills
Characterized by:
• minimal supervision for new learning
• may attend to a familiar task in a distraction-free environment for up to 30 minutes with minimal redirection
• overestimates abilities
• minimal supervision for safety in home and community routines
Classification for this level of recovery after a traumatic brain injury:
Automatic, appropriate: Minimal assistance for daily living skills
Characterized by:
• minimal supervision for new learning
• may attend to a familiar task in a distraction-free environment for up to 30 minutes with minimal redirection
• overestimates abilities
• minimal supervision for safety in home and community routines
Rancho Los Amigos Level of Cognitive
Functioning: Level VII
Classification for this level of recovery after a traumatic brain injury:
Purposeful, appropriate: Stand-by assistance
Characterized by:
• stand-by assistance for daily living skills to take corrective action when impairments interfere with task completion
• independently attends to and completes familiar tasks for one hour
• independent once a new activity is learned
Rancho Los Amigos Level of Cognitive
Functioning: Level VIII
Classification for this level of recovery after a traumatic brain injury:
Purposeful, appropriate: Stand-by assistance on request
Characterized by:
• stand-by assistance on request when impairments interfere with task completion
• can shift between tasks and can attend for a minimum of 2 hours
• uses assistive memory devices
• able to monitor appropriateness of social interactions with stand-by assistance
Rancho Los Amigos Level of Cognitive
Functioning: Level IX
Classification for this level of recovery after a traumatic brain injury:
Purposeful, appropriate: Modified independent
Characterized by:
• can independently handle multiple tasks simultaneously, but may require occasional breaks
• accurately estimates skills and abilities and independently adjusts task demands
• social behaviors are consistently appropriate
Rancho Los Amigos Level of Cognitive
Functioning: Level X
Allen Cognitive Level characterized by: • reflexive responses • responsive to internal stimuli • impaired awareness of time and place • global cognition impaired • maximum assistance for ADL
Allen Cognitive Level 1
Automatic actions
Allen Cognitive Level characterized by: • awareness of gross motor movements • global cognition impaired • may benefit from 1-step verbal instructions • requires 24-hour nursing care
Allen Cognitive Level 2
Postural actions
Allen Cognitive Level characterized by:
• ability to manipulate objects with hands
• responsive to tactile cues
• repetitive actions that are not goal directed
• short attention span and unpredictable behaviors
Allen Cognitive Level 3
Manual actions
Allen Cognitive Level characterized by: • global cognition moderately impaired • responds to tangible, visual motor cues • some goal-directed behaviors • can pay attention for up to 1 hour
Allen Cognitive Level 4
Goal-directed actions
Allen Cognitive Level characterized by:
• global cognition mildly impaired
• trial-and-error method used during activities
• decreased ability to plan ahead and anticipate errors
• poor judgement and occasionally impulsive
Allen Cognitive Level 5
Exploratory actions
Allen Cognitive Level characterized by:
• abstract thinking is intact
• carry-over of learning from one session to another
• anticipates errors and demonstrates ability to plan ahead
• judgement and problem-solving is intact
Allen Cognitive Level 6
Planned actions
