Unit 2 Tests - Explain the Test

Question 1

Berg Balance Scale (BBS)

Answer 1

14 items Assesses static balance and fall risk in adult populations Scores range from 0-4 on each item -Max Score = 56 -Score of 44 or less indicates increased risk of falls -Less than 40 in the elderly is a significant risk 0-20= high risk fall 21-40 = moderate risk fall 41-56 = low fall risk DOES NOT ASSESS GAIT Anticipatory, LOS, proactive, vision, cognition, static balance, and dynamic balance

Question 2

Performance Orientated Mobility Assessment (POMA) (Tinetti)

Answer 2

16 items (9 balance and 7 gait) -Measures balance and gait -AD can be used on test Score range 0-2 -Max score = 28 (16 for balance and 12 for gait) –Some Q’s have 0 or 1 for score 25-28 = low fall risk 9-24 = medium fall risk < 19 = high fall risk HARD TO DETECT SMALL CHANGES

Question 3

Dynamic Gait Index (DGI)

Answer 3

8 items - all gait -Modifying balance in presence of external demands -Can use AD -Score less than 19 is indicative of falling Ceiling effect in patients with vestibular disorders, especially younger patients

Question 4

Functional Gait Assessment

Answer 4

10 items (7/8 items from DGI, and 3 new items) -Can use AD on test! Highest score is 30 (0-3 scale) -Less than 22 is at risk for falls in community-dwelling older adults -Less than 20 has 100 sensitivity

Question 5

Four Square Step Test (FSST)

Answer 5

4 Canes -AD is allowed 1 practice trial and 2 timed trials -BEST TIME RECORDED -Greater than 15 seconds= increased risk for falls -Tests dynamic balance

Question 6

Timed Up and Go Test (TUG)

Answer 6

3m or 10ft track needed > 12 seconds in indicative of fall risk (time varies by literature) Normal for old people to be slow (11-20s) > 10s = independent 20-29s = normal for frail elderly or pt’s who are disabled >30s = dependent in mobility skills and most ADL

Question 7

Functional Reach Test

Answer 7

3 trials, with AVERAGE OF LAST TWO RECORDED 1 arm, closed fist, measured at 3rd MCP

Question 8

Gait Speed (Normal Pace) (10 m walk test)

Answer 8

Great predictor of future health status and functional decline in the elderly 1.2m/s-1.4m/s = community ambulation AVERAGE OF THE 3 SCORES RECORDED < 0.2 m/s =discharge to SNF 1.0 m/s -1.4m/s = less likely to have adverse event < 1.0 m/s - need interventions to reduce fall risk —- Red = < 0.6m/s high risk for falling Yellow = 0.6-1.0 m/s- elevated risk (not an emergency but interventions should be looked at) Green = 1.0+ = good

Question 9

MiniBEST

Answer 9

14 items Identify 6 different balance control systems - specific rehab approaches can be designed for different balance deficits Max Score = 28 Each item is scored 0-2 -If subject must use an AD for an item, score that category one point lower

Question 10

mCTSIB

Answer 10

4 total items (full version has 6) NO SHOES and arms crossed -Not too wide of BOS 3 trials of each item -Use average time if all trials are below 30 seconds

Question 11

Chair Stands

Answer 11

PPT says 30 seconds; Deb Kelly does it 5 times only Age 60-64: Males - < 14 is bad Females - < 12 is bad

Question 12

4-Stage Balance Test

Answer 12

NO AD, eyes open Standardized instructions and commands 10 seconds, one trial 1. Feet side by side, together 2. Semi-tandum (pick side) 3. Tandum (they pick lead foot) 4. Unilateral (they pick LE)

Question 13

Physical Performance and Mobility Examination

Answer 13

6 items - integral to everyday life -does not examine strength or ROM (Bed mobility, transfers, multiple chair stands, standing balance, step up, ambulation) -OBSERVATION -Can score P/F or use 0-3 scale -Good for frail, elderly patients

Question 14

Riverhead Mobility Index

Answer 14

15 items (14 self-report and 1 observational) -Items progress in difficulty -#5 is observation (stand for 10 seconds without UE support) 0-1 scale (no or yes) ASSESSES FUNCTIONAL MOBILITY IN PATIENTS FOLLOWING STROKE

Question 15

High-Level Mobility Assessment (HiMAT)

Answer 15

13 items (includes walking, running, jumping, stairs, hopping, and skipping). Range=0-4 Max score=54 ONLY TESTED IN PATIENTS WITH TBI

Question 16

Chedoke Arm & Hand Inventory

Answer 16

13 items Lots of items Higher score is better -Test is timed, but higher scores = lower times Used for patients with STROKE!!!!

Question 17

Motor Activity Log

Answer 17

Self-report People asked to rate quality of movement and amount of movement during functional tasks Target tasks consist of OBJECT MANIPULATION as well as USE OF THE ARM DURING GROSS MOTOR ACTIVITIES Range = 0=5 - higher scores are better PATIENTS WITH STROKE (Hemiplegia)

Question 18

Minnesota Manual Dexterity Test

Answer 18

Assess ability of the patient to place, turn, displace one hand turning and placing, two hand placing and turning. More importantly, it measures the speed of gross arm and hand movements during rapid eye-hand coordination tasks EXPENSIVE ($275) Normative data available for age and gender But LOWER TIME IS BETTER Test is applicaable in testing workers in occupations requiring quick movement in handling simple tools

Question 19

Nine Hole Peg Test

Answer 19

1 item Take pegs from one container and place them into holes on board Scores based on time -Measures finger dexterity, object manipulation, and fine motor control

Question 20

Wolf Motor Function Test

Answer 20

21 items, but the widely used version only has 17 items. 3 parts: time, functional ability, and strength 15 function-based tasks and 2 strength-based tasks Test less-affected side first Range = 0-5 Max score = 75??(function items only?) DO NOT USE WITH THOSE WITH UE SPASTICITY

Question 21

Action Arm Reach Test

Answer 21

19 items 4 sub-sets (grasp, pinch, grip, and gross arm movements) Range = 0-3 2= completes test but takes a long time or has great difficulty 1 = performs test partially Developed to assess UE function in adults with neurologic dysfunction, including those who have had a stroke

Question 22

Jebsen-Taylor Hand Function Test

Answer 22

7 Subsets: -writing, card turning, picking up small items, simulated feeding, stacking checkers, picking up light cans, and picking up heavy cans Requires BOTH hands to be tested (non-dominant first). Timed LOWER SCORE = BETTER Simulate hand functions that are common to many ADL tasks Assesses ADLs and weighted tasks

Question 23

Fugl-Meter Assessment of Physical Performance

Answer 23

THE GOLD STANDARD FOR PATIENTS WITH STROKE 5 Domains: 1. Motor function in the UE and LE 2. Sensory Function (light touch and joint position)(24) 3. Balance (14) 4. Joint ROM (44) 5. Joint Pain (44) Range = 0-2 (high score is better) Motor scores range from 0 to 100 -66 for UE -34 for LE Max score is 226

Question 24

Glascow Coma Scale

Answer 24

Developed to describe the depth and duration of impaired consciousness or coma GOLD STANDARD instrument used to document level of consciousness in acute brain injury Three aspects of function are examined (eye opening, best motor response, and verbal response) Total GCS score range from a low of 3 to a high of 15 Severe brain injury=8 or less Moderate brain injury = 9-12 Mild brain injury = 13-15

Question 25

Mini Mental Status Examination (MMSE)

Answer 25

USED TO DETECT THE PRESENCE OF COGNITIVE IMPAIRMENT (repeated use of this test has been found to reduce its validity - do not use repeatedly with the same patient) 11 simple questions and tasks (arithmetic, memory, and orientation) Observational-test Max score = 30 23 or less = cutoff indicating cognitive impairment 27 or more - no impairment 21-26 = mild 11-20 = moderate 10 or less =severe

Question 26

Montreal Cognitive Assessment (MoCA)

Answer 26

RAPID SCREEN INSTRUMENT FOR THE DETECTION OF MILD COGNITIVE IMPAIRMENT -Made in response to poor sensitivity of MMSE -May misclassify patients with aphasia (test is heavily language-dependent) -Used mainly in patients with stroke Domains: attention and concentration, executive functions, memory, language, conceptual thinking, calculations, and orientation. Sum all subscores. Add 1 point for a client who has had 12 yeas or fewer of formal education (max 30 points) 26 and above is normal Below 26 is mild cognitive impairment below 22 = likely impairment 22-27 = benefit from further evaluation 28-30 = likely indicate no impairment

Question 27

Galveston Orientation and Amnesia Test (GOAT)

Answer 27

Measure of POST TRAUMATIC AMNESIA (loss of memory immediately following injury) -Asks series of standardized questions related to orientation and the ability to recall events before and after the injury Scores between 100 and 76 are normal Scores 75 and below indicate PTA Good interrater reliability and is a valid measure

Question 28

Trail Making Test (TMT)

Answer 28

Used to test executive abilities in patients with stroke Variety of mental abilities required (letter/number recognition, mental flexibility, visual scanning, and motor function) Used for patients with STROKE AND BRAIN DAMAGE Performance evaluated using 2 different visual conceptual and visuomotor tracking conditions. Part A - connect numbers 1-25 in ascending order Part B- connecting numbers and letters in an alternating and ascending fashion Time taken is recorded. TMT Part A = 1-39 seconds TMT Part B=1-91 seconds Brain damage = TMT Part A 40 seconds or TMT Part B-92 seconds or more

Question 29

Clock Drawing Test (CDT)

Answer 29

Used to assess visuospatial and praxis abilities. May determine presence of both attention and executive dysfunctions. Used for patients with STROKE or suspected neurological pathology. No standardized score

Question 30

Star Cancellation Test

Answer 30

Used to detect the presence of UNILATERAL SPATIAL NEGLECT. Test is not highly specific 52 large stars, 13 letters, 10 short words, and 56 small stars. Max score is 54 (cross out all small stars; 2 cross out during demonstration) Cut off of less than 44 indicates unilateral neglect Contralateral hemisphere to side of neglect (can only see L stars–> damage on L hemisphere for R neglect)

Question 31

Line Bisection Test

Answer 31

Quick measure to detect the presence of unilateral neglect Used for those with stroke or unilateral TBI (R sided neglect, draw more on R side) Patient is asked to mark the center of a series of horizontal lines. Usually a displacement of the bisection mark towards the side of the brain lesion is interpreted as a symptom of neglect Test is scored by measuring the deviation of the bisection from the true center of the line. A deviation of more than 6mm from the midpoint indicates unilateral neglect. Omission of two or more lines on one half of the page also indicates unilateral neglect.

Question 32

Double Simultaneous Stimulation

Answer 32

Assesses unilateral neglect Patients with stroke No particular items Touch patient, L or R (or both)

Question 33

Point to body parts on command

Answer 33

Assesses Somatoagnosia. Patients with STROKE. No items. Cannot point to body parts on demand

Question 34

Kettle Test

Answer 34

Developed as a breif performance-based measure designed to assess COGNITIVE SKILLS in a functional context. CAn be used to evaluate capacity for independent community living in clients with cognitive impairments Used for patients with STROKE who were independent prior to stroke - also understand spoken or written language. Items include preparing hot beverages (cognitive, functional, and problem-solving skills) - 13 STEPS!!!! 0-4 for all 13 tasks LOWER SCORE IS BETTER!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Question 35

Multiple Errands Test (MET)

Answer 35

Populations with acquired brain injury, including stroke. 8 written tasks to be completed in a pedestrian shopping precinct. 6 are simple, #7 requiring being somewhere for 15 mins, and #8 has 4 sets of info that patient must obtain and write on a postcard -Inefficiencies -Rule breaks -Interpretation failure -Task failure Time is recorded! Then # of errors is calculated

Question 36

Activity-Specific Balance Confidence Scale (ABC)

Answer 36

16 item scale that asks individuals to rate overall level of self-confidence in home and community activities. 0% to 100%

Question 37

Modified Falls Efficacy Scale

Answer 37

Falling confidence scale. 14 item questionnaire. Scale of 0-10. CEILING EFFECT! Does not test community walkers. -Assesses indoor walkers only

Question 38

Modified Gait Efficacy Scale

Answer 38

Assesses older adults’ perfection of their level of confidence in walking during challenging circumstances. 10-items. Scale is 1-10. (higher score is better)

Question 39

Survey of Activities and Fear of Falling in the Elderly (SAFFE)`

Answer 39

Scale adds in dimension of: has the person restricted their activity because of fear?? 11 items

Question 40

FIM

Answer 40

18 items (13 motor and 5 cognitive). Inpatient functional outcome measure. Costs money and takes longer, but a good test nonetheless. Assess level disability and how much assistance is needed

Question 41

Barthel

Answer 41

10 items. ADL and mobility activities. No training, short, free. Used in inpatient setting.

Question 42

OPTIMAL

Answer 42

Outpatient. Self-report.