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Neuro Disorders > Functional Abilities/Examinations > Flashcards

Functional Abilities/Examinations Flashcards

1
Q

Levels of Assistance

A
  • Exam that is a gross measure of function that defines physical assistance required by a patient to do a particular activity
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2
Q

Levels of Assistance grading

A
  1. Maximum assist: Performs 25-49% of task
  2. Moderate assist: Performs 50-74% of task
  3. Minimum assist: Performs 75% or more of task
  4. Contact guard: Required hands-on guarding for balance or safety, not for actual assistance
  5. Supervision: No hands on contact but requires cuing & supervision for safety
  6. Independence: No cuing, hands-on assistance
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3
Q

Levels of assistance pros

A
  • Familiar amongst many healthcare professionals
  • Quick and easy
  • Objectivity with percentages
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4
Q

Levels of assistance cons

A
  • Some subjectivity

- Does not care about quality of movement

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5
Q

Task analysis pros

A

Breaks down quality of movement

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6
Q

Task analysis cons

A
  • Not objective - no ordinal data that is used

- Need strong appreciation of normal movement - atypical v typical

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7
Q

Get up and go test

A
  • Quick screening tool for detecting balance problems in elderly population
  • Intra-rater reliability high
  • Inter-rater reliability low
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8
Q

Get up & go test instructions

A

Stand up from chair with arms –> walk 3 meters/9.8 feet –> turn around –> return to sitting in the chair
- Assistive device can be used

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9
Q

Get up & go scoring

A 
1 = normal
2 = very slight abnormal
3 = mildly abnormal
4 = moderately abnormal
5 = severely abnormal 
- Increased risk for falls found in elderly who scores 3 or higher
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10
Q

TUG

A
  • Designed to detect BOTH functional mobility deficits and predict fall risk
  • Examines proactive/anticipatory aspects of postural control
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11
Q

TUG Directions

A
  • Measures, in seconds, the time that it takes for an individual to stand up from chair with arms, walk 3 meters (~10 feet), turn, walk back to the chair, and sit down - walking at normal pace
  • Patient uses customary walking aide and no physical assistance is given
  • Instructions: “I want you to stand up and walk to the cone, turn, then walk back to the chair and sit down”
  • Timing begins when therapist says go
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12
Q

TUG Documentation/Scoring

A
  • Time
  • Stability/instability with turns
  • Assistive device
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13
Q

TUG Cut-off scores

A
  • Community dwelling frail older adults: > 14 seconds - high fall risk
  • Post-op hip fracture at discharge: > 24 seconds - falls within 6 months after hip fracture
  • Frail older adults: > 30 seconds - predictive of requiring assistive device for ambulation & being dependent in ADLs
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14
Q

TUG Dual-Task

A
  • Examines effect of cognition on anticipatory aspects of postural control
  • TUG DT cognitive - Complete TUG while counting back by 3 seconds
  • TUG DT manual - complete TUG while carrying cup of water
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15
Q

Cut-off scores for TUG Dual task

A
  • TUG DT cognitive - > 15 seconds - overall correct prediction rate of 87%
  • TUG DT manual - > 14.5 seconds - overall correct prediction rate of 90%
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16
Q

Pedi TUG

A
  • Includes concrete tasks (touch wall), repeated instructions (behave spontaneously), and change in stop/start time (begins when child starts to rise from chair)
  • Norm reference studies still needed but it is quick, efficient, and low cost
17
Q

Pedi TUG Population

A
  • Reliable in patients without disabilities 3-9 y.o
  • Reliable in patients as young as 3 y.o provided ability to follow directions
  • Reliable in patients with physical disabilities 3-19 y.o (myelodysplasia (spina bifida) & CP)
18
Q

Timed Functional Movements

A
  • Ex. Supine to sit, sit to stand, forward & backward walking
  • Important in safety, fire emergency, track regression & progression, and dynamic balance
19
Q

Acute Care of Index of Function (ACIF)

A
  • 20 item test developed to standardize functional assessment of patients with acute neurological conditions (excellent reliability)
  • Takes 12-15 minutes
  • Subgroups: Mental status, bed mobility, transfers, mobility
20
Q

Acute Care of Index of Function (ACIF) pros & cons

A
  • Pros: Simple exam, objective, functional
  • Cons: No assessment of other factors (home environment, social support, etc.); floor and ceiling effects (not enough numbers/options); narrow approach to functional tasks
21
Q

FIM

A
  • ADL assessment instrument of functional status
  • Valid only for inpatient rehab settings (other tests are for other settings)
  • Tests motor & cognitive aspects: self-care, sphincter control, transfers, locomotion, communication, social cognition
  • Measures disability and burden of care
22
Q

FIM Scoring

A
  • 7 - Independent - complete (time and safe)
  • 6 - Independent - modified (device, safe, extra time)
  • 5 - Dependent - modified, requires supervision (cuing, coaxing, set-up
  • 4 - Dependent - Modified, requires minimal assistance (>/= 75%)
  • 3 - Dependent - Modified, requires moderate assistance (50-74%)
  • 2 - Dependent - requires maximal assistance (25-49%)
  • 1 - Dependent - requires total assistance (< 25%)
  • 0 - Never performed at admission
23
Q

FIM Pros & Cons

A
  • Pros: Comprehensive

- Cons: Community mobility not included, household ambulation not included; floor and ceiling effects

24
Q

weeFIM

A
  • Modified FIM exam for children 6 months - 7 years
25
Q

Continuous-Scale Physical Functional Performance Test (CS-PFP)

A
  • Comprehensive, in-depth measures of physical function that reflects abilities in several separate physical domains
  • Based on ordinary life activities and requires standard conditions, scripted dialogue, and training class
  • All tasks quantified by time, distance, or weight
  • 16 tasks in three levels: low effort, medium effort, hard effort
  • Older adults ages 65-85 validation
26
Q

Continuous-Scale Physical Functional Performance Test (CS-PFP) Scoring

A
  • 0-100 for each task of upper body strength, lower body strength, flexibility, balance, coordination, & endurance
  • Each task represented with time, weight carried, distance covered
27
Q

Wheelchair Skills Test (WST)

A
  • Standardized evaluation method that permits a set of representative wheelchair skills to be objective, simple, and inexpensively documented
  • Can be used in rehab program for diagnostic measure
  • Can be used for program evaluation, to answer research questions, and to assist in wheelchair design
28
Q

Functional Ambulation Category (FAC)

A
  • Categorizes subjects according to basic motor skills necessary for functional ambulation without assessing endurance
  • 6 point scale: 0 = non functional ambulation; 1, 2, 3 = dependent ambulator who requires assistance; 4, 5 = independent ambulator
29
Q

Functional Ambulation Category (FAC) Cut-off Scores

A
  • Acute stroke >4 more sensitive in predicting community ambulation at 6 months
30
Q

Observational Gait Assessment (OGA)

A
  • Organized approach to observing joint movements, timing of movements, and quality of movements during walking
  • Pros: high intra-rater
  • Cons: low inter-rater
  • Always measure gait velocity
  • In elderly, predictive of hospitalization, requirement of caregiver/nursing home placement, falls & fractures, death in healthy elderly
31
Q

10 Meter Walk Test Population

A
  • Validated in Stroke, SCI, and Parkinson’s
32
Q

10 Meter Walk Test

A
  • 0, 2, 12, 14 meter tape marks & individual is timed from 2 meters to 12 meters
  • Take vitals at the beginning, have patient walk distance, turn and come back, take vitals at the end
  • Documentation: Include time, speed (slow, moderate, fast), vitals, assistive device (keep consistent with repetition of tests)
33
Q

10 Meter Walk Test Instruction

A

“You are going to walk a distance of about 40 feet. We will repeat this distance 2 times. Both times will be completed at a comfortable pace. Do you have any questions?” :

34
Q

HiMAT

A
  • Population: high level balance TBI
  • Multiple high level activities: walking forward, backwards, on toes, over obstacle, run, skip, hop, bounding (affected & unaffected), upstairs, downstairs

Neuro Disorders (14 decks)

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