TBI outcome measures

Question 1

Adult FIM

Answer 1

18-64 years old

Question 2

What can adult FIM test for?

Answer 2

Stroke,
Traumatic brain injury,
Spinal cord injury,
Multiple Sclerosis,
Orthopedic Conditions
Elderly undergoing inpatient rehabilitation

Question 3

WeeFIM

Answer 3

children
6 months-7 years
(can include children up to 18 yrs of age with a Developmental disability)

Question 4

What does WeeFIM test for?

Answer 4

Brain injury
Burns
Multiple Diagnosis

Question 5

Level 7 FIM:

Answer 5

Complete Independence

Fully independent

Question 6

Level 6 FIM:

Answer 6

Modified Independence

required the use of a device but no physical help

Question 7

Level 5 FIM:

Answer 7

Supervision

requiring only stand-by assistance or verbal prompting or help with set up

Question 8

Level 4 FIM

Answer 8

Minimal Assistance

requiring incidental hands on help only (subject performs 75% or more of task)

Question 9

Level 3 FIM

Answer 9

Moderate Assistance

subject still performs 50-75% of the task

Question 10

Level 2 FIM

Answer 10

Maximal Assistance

subject provides less than half of the effort (25-49%)

Question 11

Level 1 FIM

Answer 11

Total Assistance

subject contributes less than 25% of the effort or is unable to do the task

Question 12

Description of FIM

Answer 12

Motor has 13 items

Socio-Cognitive has 5 items

Question 13

Maximal FIM score:

Answer 13

126= functional independence

Question 14

Minimal FIM score:

Answer 14

18= complete functional dependence

Question 15

Timeframe for FIM:

Answer 15

The score should be collected within 72 hours of admission to rehab hospital, and within 72 hours before discharge

Question 16

Coma Recovery Scale Revised:

Answer 16

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

Question 17

Moss Attention Rating Scale

Answer 17

observational tool used to measure attention-related behaviors after TBI

Question 18

Agitated Behavioral Scale:

Answer 18

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

Question 19

Apathy Evaluation Scale

Answer 19

method for measuring apathy resulting from brain-related pathology

Question 20

Balance Error Scoring System:

Answer 20

assesses static postural stability (designed for mild head injury to assist in return to sports play decisions)

Question 21

BESS conditions:

Answer 21

Double leg stance: firm/foam
Single leg stance: firm/foam
Tandem stance: firm/foam

Question 22

Cog-log and O

Answer 22

measures general cognitive abilities, companion to orientation log

Question 23

Community balance and mobility scale

Answer 23

used to detect high level balance and mobility deficits based on tasks that are commonly encountered in community environments

Question 24

Disorders of Consciousness Scale

Answer 24

bedside test measuring neurobehavorial functioning during coma recovery

Question 25

Dizziness Handicap Inventory

Answer 25

24 item self assessment inventory designed to evaluate self perceived handicap effects imposed by dizziness

Question 26

Disability Rating Scale

Answer 26

developed and tested with older juvenile and adult individuals with moderate and severe traumatic brain injury (TBI) in an inpatient rehabilitation setting

Question 27

Functional Assessment Measurement

Answer 27

12 items added to FIM to enhance its utility for brain injury population

Question 28

PT Considerations RLO I -III

Answer 28

- maintain ROM; prevent contractures, positioning - skin integrity - maintain respiratory status - provide sensory stimulation

Question 29

PT Considerations RLO IV-VI

Answer 29

- provide structure/consistency - emphasize safety - provide verbal/physical assistance - task specific training

Question 30

PT Interventions for LOCF VII-VIII

Answer 30

- allow for increasing independence (closed to open environment) - promote independence functional tasks - assist in behavioral, cognitive, emotional reintegration

Question 31

Advantages of spasticity:

Answer 31

maintains muscle tone/mass reduces bone loss promotes blood circulation helps with performance

Question 32

Disadvantages of spasticity:

Answer 32

``` limits ROM pain interferes with daily function affects posture increases risk for skin breakdown ```

Question 33

What is Heterotopic Ossification (HO)?

Answer 33

Abnormal bone formation in soft tissue and muscles surrounding joints

Question 34

When does HO happen?

Answer 34

Happens after injury to the brain or spinal cord

Question 35

Symptoms of HO?

Answer 35

Loss of ROM, Pain on movement, localized swelling & erythema

Question 36

Tonic labyrinthine reflexes | Prone position

Answer 36

increased flexor tone/flexion of all limb

Question 37

Tonic labyrinthine reflexes | Supine position:

Answer 37

increased extensor tone/extension of all limbs

Question 38

Asymmetrical tonic neck reflex (ATNR)

Answer 38

rotation of head to one side | flexion of skull limbs, extension of jaw limbs, bow and arrow or fencing posture

Question 39

Symmetrical tonic reflex | Head flexion

Answer 39

Flexion of UE, extension of LE

Question 40

Symmetrical tonic reflex | Head Extension

Answer 40

Extension of UE, flexion of LE

Question 41

Most desirable position in inpatient rehab?

Answer 41

side lying | prone

Question 42

UE Flexion Synergy

Answer 42

``` scapular retraction/elevation or hyperextension shoulder abduction, ER elbow flexion forearm supination wrist and finger flexion ```

Question 43

LE Flexion Synergy

Answer 43

hip flexion, abduction, ER knee flexion ankle dorsiflexion, inversion toe dorsiflexion

Question 44

UE Extension Synergy:

Answer 44

``` scapular protraction shoulder adduction, IR elbow extension forearm pronation wrist and finger flexion ```

Question 45

LE Extension Synergy:

Answer 45

Hip extension, adduction, IR knee extension ankle plantarflexion, inversion toe plantarflexion