Balance Assessments Flashcards
- Bedside evaluation of sitting balance that evaluates sensory, motor, proactive, reactive, and steady state balance factors
- purpose is to assess functional sitting abilities, describe sitting balance dysfunction, focus on interventions, and track changes in sitting balance over time
- also provides a form of assessment of lower level patients, especially if other balance tests may be too difficult for the patient
Function In Sitting Test (FIST)
- 14 functional sitting ability tests
- can usually be done in under 10 minutes
What populations would the FIST be appropriate for?
patients with:
- Ability to follow simple directions, either verbal or nonverbal
- Known or suspected sitting balance deficits
- Impulsiveness
- Safety issues in sitting
- Slow movement
- Poor seated motor control
Or Lower level patients who:
- cannot tolerate other balance tests
- are unable to stand or ambulate without excessive assistance or devices
Tests gait and balance abilities in older adults; Determines level of fall risk; Aimed to develop a measure to screen older adults for balance and gait impairments that was feasible for use, was reliable and sensitive to significant changes, and reflected position changes and gait maneuvers used during daily activities
Tinetti
- takes 10-15 minutes
- 16 tasks; 9 balance, 7 gait
- scored 0-2
What is the score breakdown on the Tinetti? what is the MDC in older adults? What is the cut off shore?
- Total possible 28 points - 12 gait, 16 balance
- MDC = 4 points
- cut off = 19, high fall risk
Objective measure used to assess balance and fall risk in adult population; Description of test: 14 item scale testing balance with transfers, static and dynamic activity; limitations is it has a high ceiling effect for higher level patients, it doesn’t assess gait
Berg balance scale
What is the MDC in the eldery population for the berg?
- 4 points if pt initially scored 45-56, 5 points if they scored 35-44, 7 points if they scored 25-34, and 5 points if they scored 0-24
What are the cut off scores for the berg?
21-40 = medium fall risk
less than 20 = high fall risk
Purpose: Assesses mobility, balance, walking ability, and fall risk in older adults
Description: The patient sits in the chair withhis/her back against the chair back. On the command “go”, the patient rises from the chair, walks 3 meters at a comfortable and safe pace, turns around at the line, walks back to the chair and sits down. Timing begins at the instruction “go” and stops when the patient is seated. Patient mustuse the same assistive device each timehe/she is tested to be able to compare scores
TUG
What is the TUG cut off score for community dwelling adults?
> 13.5s
Purpose - Assess a patient’s dynamic stability by measuring the maximum distance an individual can reach forward while standing (or sitting) in a fixed position
Description – The patient is instructed to stand close to, but not touching, a wall and position the arm that is closer to the wall at 90 degrees of shoulder flexion with a closed fist. The assessor records the starting position at the 3rd metacarpal head on the yardstick. Instruct the patient to “Reach as far as you can forward without taking a step”. The location of the 3rd metacarpal is recorded. The difference between the start and end position is the reach distance, usually measured in inches. The test allows for 4 total trials: 1 practice trial, followed by 3 “test” trials. The distances of the last 3 trials are averaged to obtain the patient’s score. Can perform seated, measuring the acromion
Functional reach test and modified functional reach test
What is the cut off score for community dwelling elderly for the functional reach test?
<7 inches
Assess the likelihood of falls in older adults, designed to test 8 facets of gait
Description of test: Performed with a marked distance of 20 feet. Can be performed with or without an assistive device. Scores are based on a 4-point scale: Highest possible score is 24 points
Tasks include: Steady state walking, Walking with changing speeds, Walking with head turns both horizontally and vertically, Walking while stepping over and around obstacles, Pivoting while walking, and Stair climbing
DGI
What is the cutoff score for the DGI?
< or equal to 19 = high fall risk
> 22 = safe ambulator
Purpose: To assess postural stability during various walking tasks
Description of Test: This test is a modification of the Dynamic Gait Index developed to improve reliability and decrease the ceiling effect. 10-item test that comprises 7 of the 8 items from the original DGI (Eliminated 1 item from original DGI, ambulation around obstacles, Added 3 new items to the original DGI, including gait with narrow base of support, ambulating backwards, and gait with eyes closed were added). 10 items; each item is scored on an ordinal scale from 0- 3. Highest score = 30. Assessment may be performed with or without an assistive device
Functional Gait Assessment
Purpose: a clinical balance assessment tool that aims to target and identify 6 different balance control systems so that specific rehabilitation approaches can be designed for different balance deficits
Description: a 14-item test scored on a 3 level ordinal scale. Scoring is 3 levels (0 - 2). Total score = 28 points per test directions
Mini BESTest
- Shortened version of the Balance Evaluation Systems Test (BESTest)
- The BESTest was shortened based on factor analysis to include dynamic balance only and to improve clinical utilization
- original scoring BESTest was 4 level (0 - 3), reduced to 3 level for redundancy
