TBI outcome measures Flashcards
Adult FIM
18-64 years old
What can adult FIM test for?
Stroke, Traumatic brain injury, Spinal cord injury, Multiple Sclerosis, Orthopedic Conditions Elderly undergoing inpatient rehabilitation
WeeFIM
children
6 months-7 years
(can include children up to 18 yrs of age with a Developmental disability)
What does WeeFIM test for?
Brain injury
Burns
Multiple Diagnosis
Level 7 FIM:
Complete Independence
Fully independent
Level 6 FIM:
Modified Independence
required the use of a device but no physical help
Level 5 FIM:
Supervision
requiring only stand-by assistance or verbal prompting or help with set up
Level 4 FIM
Minimal Assistance
requiring incidental hands on help only (subject performs 75% or more of task)
Level 3 FIM
Moderate Assistance
subject still performs 50-75% of the task
Level 2 FIM
Maximal Assistance
subject provides less than half of the effort (25-49%)
Level 1 FIM
Total Assistance
subject contributes less than 25% of the effort or is unable to do the task
Description of FIM
Motor has 13 items
Socio-Cognitive has 5 items
Maximal FIM score:
126= functional independence
Minimal FIM score:
18= complete functional dependence
Timeframe for FIM:
The score should be collected within 72 hours of admission to rehab hospital, and within 72 hours before discharge
Coma Recovery Scale Revised:
The scale consists of 23 items that comprise six subscales addressing auditory, visual, motor, oral motor, communication and arousal functions. CRS-R subscales are comprised of heirachically-arranged items associated with brain stem, subcortical and cortical processes
Moss Attention Rating Scale
observational tool used to measure attention-related behaviors after TBI
Agitated Behavioral Scale:
assess the nature and extent of agitation during the acute phase of recovery from acquired brain injury
Its primary purpose is to allow serial assessment of agitation by treatment professionals who want objective feedback about the course of a patient’s agitation
Apathy Evaluation Scale
method for measuring apathy resulting from brain-related pathology
Balance Error Scoring System:
assesses static postural stability (designed for mild head injury to assist in return to sports play decisions)
BESS conditions:
Double leg stance: firm/foam
Single leg stance: firm/foam
Tandem stance: firm/foam
Cog-log and O
measures general cognitive abilities, companion to orientation log
Community balance and mobility scale
used to detect high level balance and mobility deficits based on tasks that are commonly encountered in community environments
Disorders of Consciousness Scale
bedside test measuring neurobehavorial functioning during coma recovery
Dizziness Handicap Inventory
24 item self assessment inventory designed to evaluate self perceived handicap effects imposed by dizziness
Disability Rating Scale
developed and tested with older juvenile and adult individuals with moderate and severe traumatic brain injury (TBI) in an inpatient rehabilitation setting
Functional Assessment Measurement
12 items added to FIM to enhance its utility for brain injury population
PT Considerations RLO I -III
- maintain ROM; prevent contractures, positioning
- skin integrity
- maintain respiratory status
- provide sensory stimulation
PT Considerations RLO IV-VI
- provide structure/consistency
- emphasize safety
- provide verbal/physical assistance
- task specific training
PT Interventions for LOCF VII-VIII
- allow for increasing independence (closed to open environment)
- promote independence functional tasks
- assist in behavioral, cognitive, emotional reintegration
Advantages of spasticity:
maintains muscle tone/mass
reduces bone loss
promotes blood circulation
helps with performance
Disadvantages of spasticity:
limits ROM pain interferes with daily function affects posture increases risk for skin breakdown
What is Heterotopic Ossification (HO)?
Abnormal bone formation in soft tissue and muscles surrounding joints
When does HO happen?
Happens after injury to the brain or spinal cord
Symptoms of HO?
Loss of ROM, Pain on movement, localized swelling & erythema
Tonic labyrinthine reflexes
Prone position
increased flexor tone/flexion of all limb
Tonic labyrinthine reflexes
Supine position:
increased extensor tone/extension of all limbs
Asymmetrical tonic neck reflex (ATNR)
rotation of head to one side
flexion of skull limbs, extension of jaw limbs, bow and arrow or fencing posture
Symmetrical tonic reflex
Head flexion
Flexion of UE, extension of LE
Symmetrical tonic reflex
Head Extension
Extension of UE, flexion of LE
Most desirable position in inpatient rehab?
side lying
prone
UE Flexion Synergy
scapular retraction/elevation or hyperextension shoulder abduction, ER elbow flexion forearm supination wrist and finger flexion
LE Flexion Synergy
hip flexion, abduction, ER
knee flexion
ankle dorsiflexion, inversion
toe dorsiflexion
UE Extension Synergy:
scapular protraction shoulder adduction, IR elbow extension forearm pronation wrist and finger flexion
LE Extension Synergy:
Hip extension, adduction, IR
knee extension
ankle plantarflexion, inversion
toe plantarflexion
