SCALES TO KNOW Flashcards

1
Q

The Modified Ashworth Scale

For Tone

A
  • Controlled, but rapid PROM @ ea. jt t/o ROM
  • Limb should be @ rest w/ pt pos’d comfortably
  • Score mm group 0-4/4
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2
Q

Modified Ashworth

Grade 0

A
  • NO INC in mm tone
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3
Q

Modified Ashworth

Grade 1

A
  • SLIGHT inc in mm tone, manifested by a catch and release OR by min resistance @ the end range of motion when part is moved
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4
Q

Modified Ashworth

Grade 1+

A
  • SLIGHT inc in mm tone, manifested by a catch, followed by MIN resistance t/o remainder (<50%) of ROM
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5
Q

Modified Ashworth Scale

Grade 2

A
  • MORE marked INC in mm tone through MOST (>50%) of ROM, but affected part is easily moved
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6
Q

Modified Ashworth Scale

Grade 3

A
  • CONSIDERABLE INC in mm tone, passive mvmt is difficult
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7
Q

Modified Ashworth Scale

Grade 4

A
  • Affected part is rigid in position
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8
Q

Glasgow Coma Scale

GCS

Acquired Brain Injury

A
  • Done in the field AND @ 24hrs
  • Predictive, BUT not localizing
  • 3 Components
    • Eye opening
    • Best motor response
    • Best verbal response
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9
Q

Glasgow Coma Scale

Scores Explained…

A
  • Score of 8 or LESS→ Coma
    • correlated w/ need for long-term care
  • Score range: 3-15
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10
Q

Glasgow Coma Scale

Eye Opening

A

4- spontaneous eye opening

3- Open to command

2- Open to painful stimuli

1- NO RESPONSE

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11
Q

Glasgow Coma Scale

Best Motor Response

A

6- Obeys command

5- Localizes

4- Withdraws

3- Decorticate posturing→ FLEXED

2- Decerebrate (all the e’s)→ EXT (worse vs. decorticate)

1- NO RESPONSE

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12
Q

Glasgow Coma Scale

Best Verbal Response

A

5- Oriented

4- Responsive BUT disoriented

3- Inappropriate

2- Moans

1- NO RESPONSE

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13
Q

Rancho Los Amigos Scale for Cognitive Functioning

Acquired Brain Injury

A

see pics

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14
Q

RLA Scale

Level I: No Response

A

Lvl 1: No Response

  • Indiv is in a deep coma and does NOT respond to ANY outside stimuli
    • verbal, touch
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15
Q

RLA Scale

Lvl II: Generalized Response

A

Lvl 2: Generalized Response

  • Individual sleeps MOST of the time, awake for only brief pds.
  • Responses and body mvmts are reflexive and NON-purposeful
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16
Q

RLA Scale

Lvl III: Localized Response

A

Lvl 3: Localized Response

  • Individual is alert for more than brief pds.
  • Reacts to commands inconsistently, but responses are specific to the type of stimuli
    • ex. touch may produce w/draw
17
Q

RLA Scale

Lvl IV: Confused and Agitated

A

Lvl 4: Confused and Agitated

  • Indiv’s behavior shows marked confusion and agitation as awareness Inc’s.
  • Behavior may be aggressive and inappropriate, speech may be incoherent.
  • Indiv NOT able to actively participate in tx due to lack of attn
  • Cannot perform ADLs
18
Q

RLA Scale

Lvl V: Confused, Inappropriate, NON-agitated

A

Lvl 5: Confused, Inappropriate, Non-agitated

  • Indiv shows inconsistent ability to follow commands
  • LTM is returning
  • Well-known skills such as eating return, however, complex tasks are diff as are NEW skills and retention
19
Q

RLA Scale

Lvl VI: Confused, Appropriate

A

Lvl 6: Confused, Appropriate

  • Indiv begins to demo. goal-oriented behavior w/ assist
  • Indiv now aware of their diff’s and familiar people
  • Retention of re-learned skills is improved→ and can be used in other situations
20
Q

RLA Scale

Level VII: Automatic, Appropriate

A

Lvl 7: Automatic, Appropriate

  • Indiv performs ADLs w/ more ease and is able to learn new skills
  • Noticeable impairment still exists in:
    • STM
    • Problem-solving
21
Q

RLA Scale

Lvl VIII: Purposeful, Appropriate

A

Lvl 8: Purposeful, Appropriate

  • Indiv is able to function w/in community even w/ cont’d impairment in cognitive ability, and social/emotional ability
22
Q

Classification of SCI:

ASIA Scale

A
  • Most used class. system for SCI
  • Sensory & Motor lvls tested
23
Q

Classification of SCI:

ASIA Scale

Sensory Testing

A
  • Based on 28 dermatomes
  • Grading
    • 2= intact
    • 1= impaired
    • 0= absent
24
Q

Classification of SCI:

ASIA Scale

Motor Testing

A
  • NOT standardized MMTs PTs reg perform
  • To det. lvl of innervation– tester looks for strength of 3/5 & @ least 4/5 in the next most rostral (superior) muscle
    • tells us this is the last intact muscle
25
Q

Classification of SCI:

ASIA Scale

ASIA A= Complete

A

A= Complete

  • NO motor OR sensory function is preserved in the sacral segments S4-S5
26
Q

Classification of SCI:

ASIA Scale

ASIA B= Incomplete

A

B= Incomplete

  • Sensory, but NOT motor function is preserved below neuro. lvl & INCLUDES sacral segments S4-S5
  • ** Incomplete– has to be able to detect deep anal pressure
    • NO anal contraction BUT DO have deep anal pressure
27
Q

Classification of SCI:

ASIA Scale

ASIA C= Incomplete

A

C= Incomplete

  • Motor function IS preserved below neuro. lvl and more than half of key muscles BELOW neuro. lvl have mm grade <3/5 (LESS THAN 3/5)
28
Q

Classification of SCI:

ASIA Scale

ASIA D= Incomplete

A

D= Incomplete

  • Motor function IS preserved below neuro lvl, and at least HALF of key mm’s below neuro lvl have muscle grade >3/5 (GREATER than 3/5)
29
Q

Classification of SCI:

ASIA Scale

ASIA E= NORMAL

A

E= Normal

  • Motor AND Sensory function are NORMAL
30
Q

Classification of SCI:

ASIA Scale

Remember this!!!

A
  • Absence of a fully functioning spinal lvl should NOT prevent the attempt to strengthen the mm’s innervated by that lvl
    • Improvements in strength by:
      • Nerve regen
      • Hypertrophy of remaining motor units
      • Improved motor control and motor learning