Tests and Measures Flashcards
What is the primary concern of patients, PT, and families when taking measurements according to the ICF model?
Activity
What is a good measure to make a prognosis according to the ICF model?
Body function and structure
What part of the ICF model can indicate effectiveness of an intervention?
Body function and structure
What document is specifically designed to guide analysis of measurement tools?
EDGE document (Evaluation Database to Guide Effectiveness)
(true/false) EDGE documents allows for integration of data from multiple studies
true
definition: The smallest amount of change that can be considered above the threshold for error in the measurement.
MDC
definition: The smallest change in an outcome measure that is perceived as beneficial by the patient, and that would lead to a change in the patient’s medical management.
MCID
Tests for ___:
- beck depression inventory
- geriatric depression scale (GDS)
fatigue
Tests for ___:
- light touch
- sharp/dull
- 2-point discrimination
Exteroreception
Tests for ___:
- joint position sense
- kinesthesia test (mirroring test)
proprioception
Tests for ___:
- Dual simultaneous stimulation
- Stereognosis
- Graphesthesia
cortical sensory tests
What are 3 multi-categorial measures?
- Fugl-Meyer Assessment (FMA)
- NIH Stroke Scale (NIHSS)
- Stroke Impact Scale (SIS)
definition: Observational rating scale to provide a reliable, quantitative and valid measure of attention-related behavior after TBI.
–> 22 items
–> 5 point scale
Moss Attention Rating Scale (MARS)
What are the 3 correlated factors being tested w/ MARS?
- Restlessness/ Distractibility
- Initiation
- Sustained/ Consistent Attention
When should you NOT use MARS?
If the patient is Rancho Level IV or higher
What patient population is it most appropriate to use the MARS test on?
Those with moderate to severe attention deficits
definition:
- Developed to assess the nature and extent of agitation during the acute phase of recovery from acquired brain injury
- Primary purpose is to allow serial assessment of agitation by treatment professionals
agitated behavior scale (ABS)
For Agitated behavior scale (ABS), any scores < ____ are considered within normal limits.
< 21
For Agitated behavior scale (ABS), any scores from ____ - ____ are indicative of mild agitation.
22-28
For Agitated behavior scale (ABS), any scores from ____ - ____ are indicative of moderate agitation.
29-35
For Agitated behavior scale (ABS), any scores > ____ are considered severe agitation.
> 35
The ABS is considered as a (observational/self-report) measure.
observational measure
definition: Used to document level of consciousness and grade coma severity over time
Glasgow Coma Scale (GCS)
GCS of < ____ is severe/comatose
< 8
GCS of __-__ is moderate disability
9-12
GCS of ___-___ is mild disability
13-15
What are the three elements of the GCS?
- eye opening
- motor response
- verbal response
(true/false) You can get an accurate score on the GCS even if the patient is fearful, agitated, and/or were sedated recently
FALSE
A GCS score 2-7 days post-op is highly predictive of outcome at ___ months.
6 months
What is the most widely used measure of injury severity?
GCS
What are the 5 levels of the Glasgow Outcome Scale (GOS)?
- Dead
- Vegetative
- Severe Disability
- Moderate disability
- Good recovery
Purpose of the scale is to assist with:
- differential diagnosis
- prognostic assessment
- treatment planning in patients with DOC/brain injury
CRS-R
What are the 6 subscales of the CRS-R from the 23 items?
- auditory
- visual
- motor
-oromotor - communication
- arousal
What are the pros of the CRS-R?
Captures emergence from a coma and the progression through disorders of consciousness
What are the cons of the CRS-R?
Requires training
Despite training still some disagreement re: scoring
May be time consuming depending on level of severity
Used primarily with TBI
CRS-R is primarily used with what injuries?
TBI
definition: Behavioral classification with 8 descriptive categories
Rancho los amigos LOC functioning
(true/false) Patients can have components of several levels of Rancho Los Amigos classifications
true
What are the 8 areas assessed by the Scale for the Assessment and Rating of Ataxia (SARA)?
- gait
- stance
- sitting
- speech
- finger chase
- nose to finger test
- fast alternating hand movements
- heel to shin slide
What is the target population for the Stroke Rehabilitation Assessment of Movement (STREAM)?
- stroke
- patients with varying degrees of motor function
STREAM consists of ___ items divided into 3 subscales… what are the subscales?
30 items (UE motor function, LE motor function, basic mobility)
(true/false) A 4 point scale for Stream allows for independence with an AD.
true
What is the maximum score for a STREAM test? How are they distributed between the subgroups?
70
- LE motor function: 20
- UE motor function: 20
- Basic mobility: 30
How long does it normally take to complete a STREAM test?
15-20 minutes
What are the pros of the STREAM test?
- Appropriate for wide range of patients
- Administration can be divided among team members (OT/PT)
- Quantifies something already being assessed
- Well-organized
- No special equipment
- Standardized verbal directions
What are cons of the STREAM test?
- May be difficult to use with cognitive/communication impairments
- Some training (?)/practice required
- Scoring requires several steps- may not be able to complete in presence of patient
The STREAM test is most appropriate first ____ months of injury when gains are expected in motor recovery
3 months
What is the target population for the trunk control test (TCT)?
post-stroke population
What are the 4 items of the TCT test?
- roll to weak side
- roll to strong side
- balance in sitting position on EOB w/ the feet off of the ground for at least 30 seconds
- sit up from lying down
What are the 3 possible scores of the TCT test? What do they mean?
0: unable to do without assistance
12: able to do so using non-muscular help or in an abnormal style… uses arms to steady themself when sitting
25: able to complete the task normally
Trunk balance in the acute stage of stroke is a ____ outcome predictor
functional outcome predictor
What are pros of the TCT?
Fast and easy to administer
Assessment items are inherent in the exam
No equipment necessary
TCT showed good sensitivity to change in assessing recovery of stroke patients
TCT construct validity was confirmed by the correlation with FIM scores
definition: Measures the functional cost of shoulder pain in wheelchair users
Wheelchair Users Shoulder Pain Index (WUSPI)
The WUSPI has ___ items covering 4 subsections… what are they?
15 items
- transfers
- WC mobility
- self care
- general activities
The WUSPI has a (observational/self-report) format
self-reporting
What is the maximum score on the WUSPI indicating extreme pain?
150 points (0-10 points for each item)
What is a simple and effective joint specific method of quickly determining the degree of interference due to pain when doing typical tasks of daily living?
WUSPI
(true/false) The majority of research of the WUSPI for reliability and validity has been conducted using a mixed sample (not just SCI) which is good.
FALSE
15-item neurologic examination stroke scale:
levels of consciousness
language
neglect
visual-field loss
extra-ocular movement
motor strength
ataxia
dysarthria
sensory loss
NIH stroke Scale (NIHSS)
What is more appropriate for Lower Level patients when assessing stroke… STREAM or NIHSS?
NIHSS
definition: developed to quantify high-level mobility outcomes following traumatic brain injury (TBI)
- Can be used to quantify high-level mobility on people with severe cognitive impairment
High level mobility assessment tool (HiMAT)
(true/false) HiMAT was not very reliable or valid.
FALSE (it was)
(true/false) Predictive validity of the NIHSS three months after stroke is not high.
FALSE
What is a reliable tool for rapidly assessing effects of a stroke?
NIHSS
definition: Scale used to measure performance in basic Activities of Daily Living
–>Ten variables describing ADLs and mobility.
barthel index
A (lower/higher) score on the barthel index is associated with greater likelihood of being able to live at home with a degree of independence following discharge from the hospital.
Higher
(true/false) The Barthel index scale is regarded as reliable, although its use in clinical trials in stroke medicine is inconsistent.
true
definition: an instrument developed to provide a “uniform method for describing the severity of disability and the functional outcomes of medical rehabilitation”.
Functional Independence Measure (FIM)
What levels of the ICF model does the FIM primarily measure?
Activity and participation
The FIM has ___ items with 2 domains… what are the domains?
18 items
- motor
- cognition
What functional test is used with all diagnoses in a rehab population?
FIM
FIM scoring is __-__ with ___ being categorized as complete independence and a __ as a total assist
scoring is 1-7
7: completely independent
1: total assist (less than 25% of task being independently performed)
A FIM score < ___ requires another person for supervision or assistance.
< 6
When are FIM tests administered?
Administered within 72 hours after admission and 72 hours before discharge
___ measures:
Craig Handicap Assessment and Reporting Technique (CHART)
Disability Rating Scale (DRS)
Satisfaction With Life Scale (SWLS)
Short Form 36 (SF-36)
Stroke Impact Scale (SIS)
participation measures
definition: Designed to provide a simple, objective measure of the degree to which impairments and activity limitations result in participation restriction
Craig Handicap Assessment and Reporting Technique (CHART)
How is CHART administered?
By interview
Each domain/subscale of CHART has a max score of ____ points.
100 points
A Higher CHART subscale score indicates (less/more) impairment
less impairment
CHART was originally developed for those with ___.
SCI
definition: Developed and tested with older juvenile and adult individuals with moderate and severe traumatic brain injury (TBI) in an inpatient rehabilitation setting
Disability Rating Scale (DRS)
The first three items of the DRS (“Eye Opening,” “Communication Ability” and “Motor Response”) are a slight modification of the _______ Scale
Glasgow Coma Scale
What items of the DRS reflect impairment?
- eye opening
- communication
- motor response
What items of DRS reflect the level of disability?
Cognitive ability for:
- feeding
- toileting
- grooming
(true/false) DRS covers a large span of recovery
True (coma to community)
(true/false) You can score DRS through a medical record review or through direct assessment
true
DRS has a (low/high) sensitivity
low
definition:
- A measure of life satisfaction developed by Ed Diener and colleagues
- Easier to use in a small clinic
Based on the theory that subjective well being has at least three components:
- positive affective appraisal
- negative affective appraisal
- life satisfaction
Satisfaction with life scale (SWLS)
The test-retest reliability of the SWLS is (non-acceptable/acceptable)
acceptable
definition: Multi-purpose, short-form health survey with only 36 questions that can be used in all settings
- Gold Standard
- Generic QOL measure
Short Form 36 (SF-36)
(true/false) SF-36 is not valid and/or reliable
false (it is)
definition: Scale that is an Individual’s perception of their status post-stroke
8 domains, 59 items:
- Strength
- Hand function
- ADL/IADL
-Mobility
- Communication
- Emotion
- Memory and thinking
- Participation/role function
Stroke impact scale (SIS)
