SCALES TO KNOW Flashcards
The Modified Ashworth Scale
For Tone
- Controlled, but rapid PROM @ ea. jt t/o ROM
- Limb should be @ rest w/ pt pos’d comfortably
- Score mm group 0-4/4
Modified Ashworth
Grade 0
- NO INC in mm tone
Modified Ashworth
Grade 1
- SLIGHT inc in mm tone, manifested by a catch and release OR by min resistance @ the end range of motion when part is moved
Modified Ashworth
Grade 1+
- SLIGHT inc in mm tone, manifested by a catch, followed by MIN resistance t/o remainder (<50%) of ROM
Modified Ashworth Scale
Grade 2
- MORE marked INC in mm tone through MOST (>50%) of ROM, but affected part is easily moved
Modified Ashworth Scale
Grade 3
- CONSIDERABLE INC in mm tone, passive mvmt is difficult
Modified Ashworth Scale
Grade 4
- Affected part is rigid in position
Glasgow Coma Scale
GCS
Acquired Brain Injury
- Done in the field AND @ 24hrs
- Predictive, BUT not localizing
- 3 Components
- Eye opening
- Best motor response
- Best verbal response
Glasgow Coma Scale
Scores Explained…
- Score of 8 or LESS→ Coma
- correlated w/ need for long-term care
- Score range: 3-15
Glasgow Coma Scale
Eye Opening
4- spontaneous eye opening
3- Open to command
2- Open to painful stimuli
1- NO RESPONSE
Glasgow Coma Scale
Best Motor Response
6- Obeys command
5- Localizes
4- Withdraws
3- Decorticate posturing→ FLEXED
2- Decerebrate (all the e’s)→ EXT (worse vs. decorticate)
1- NO RESPONSE
Glasgow Coma Scale
Best Verbal Response
5- Oriented
4- Responsive BUT disoriented
3- Inappropriate
2- Moans
1- NO RESPONSE
Rancho Los Amigos Scale for Cognitive Functioning
Acquired Brain Injury
see pics
RLA Scale
Level I: No Response
Lvl 1: No Response
- Indiv is in a deep coma and does NOT respond to ANY outside stimuli
- verbal, touch
RLA Scale
Lvl II: Generalized Response
Lvl 2: Generalized Response
- Individual sleeps MOST of the time, awake for only brief pds.
- Responses and body mvmts are reflexive and NON-purposeful
RLA Scale
Lvl III: Localized Response
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
RLA Scale
Lvl IV: Confused and Agitated
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
RLA Scale
Lvl V: Confused, Inappropriate, NON-agitated
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
RLA Scale
Lvl VI: Confused, Appropriate
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
RLA Scale
Level VII: Automatic, Appropriate
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
RLA Scale
Lvl VIII: Purposeful, Appropriate
Lvl 8: Purposeful, Appropriate
- Indiv is able to function w/in community even w/ cont’d impairment in cognitive ability, and social/emotional ability
Classification of SCI:
ASIA Scale
- Most used class. system for SCI
- Sensory & Motor lvls tested
Classification of SCI:
ASIA Scale
Sensory Testing
- Based on 28 dermatomes
- Grading
- 2= intact
- 1= impaired
- 0= absent
Classification of SCI:
ASIA Scale
Motor Testing
- 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
Classification of SCI:
ASIA Scale
ASIA A= Complete
A= Complete
- NO motor OR sensory function is preserved in the sacral segments S4-S5
Classification of SCI:
ASIA Scale
ASIA B= Incomplete
B= Incomplete
- Sensory, but NOT motor function is preserved below neuro. lvl & INCLUDES sacral segments S4-S5
Classification of SCI:
ASIA Scale
ASIA C= Incomplete
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)
Classification of SCI:
ASIA Scale
ASIA D= Incomplete
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)
Classification of SCI:
ASIA Scale
ASIA E= NORMAL
E= Normal
- Motor AND Sensory function are NORMAL
Classification of SCI:
ASIA Scale
Remember this!!!
- 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
- Improvements in strength by:
