Outcome measure flashcards
(143 cards)
1
Q
What are the highly recommended outcome measures in the acute stage for CVA?
A
- Orpington prognostic scale
- 6MWT
- 10MWT
- Functional Reach
- PASS
- TUG
2
Q
What are the highly recommended outcome measures in the IP and OP rehab setting for CVA?
A
6MWT 10MWT Functional Reach PASS TUG FIM (IP only) Goal Attainment Scale Motor Activity log (upper limb performance) Stroke Impact Scale (OP only)
3
Q
Describe the categories for the NIH Stroke Scale
A
Recommended at all stages and levels of care (grade severity of stroke) 0-42 points total 1-5- Mild 5-14-Moderate 15-24-Severe >25- very severe
4
Q
What are the prognostic values for the Orpington Prognostic Scale?
A
3.2.-5.2= respond better to rehab <3.2= DC home >5.2= institutionalized
Acute care setting only!
5
Q
What score on the Cherokee McMaster Stroke Assessment is indicative of individual being able to ambulate INDEP?
A
> 9 on the postural control and leg scores
Higher scores are better
1 is flaccid and 7 is normal movement
-Out of 100; higher score is better
6
Q
What is a typical hand grip strength for normal men/women?
A
100# for men, 65# for women
7
Q
How is the Tinetti Falls Efficacy Scale rated?
A
On a scale from 1-10, 1 very confident and 10 not confident, rate doing following activities without falling
Activity, participation, self reported measure for rating balance confidence
> 70 points- fear of falling
80 points- risk for falling
8
Q
Fugyl-Meyer Score
A
10-25- no fine motor skills required
25-45- working on grasp/release
45-56- work on fine motor skills
(make sure this card is correct)
9
Q
Modified Rankin Scale
A
Looks at assistance level required for self care, ADLs, and overall function
- Self report, observation measure
- 0-5 (0 no symptoms, 5 bed ridden)
Time to achieve INDEP level
Score of 3= 96 days
(make sure this card is correct)
10
Q
What area of the ICF does the Modified Rankin Scale measure?
A
Participation
11
Q
Barthel Index
A
Shows individual’s ability to care for self
10 ADL items rated based on level of assist the P requires
0-100
Higher the better
Lower admission score= greater change in score at DC
43.7/80.5
12
Q
Functional Ambulation Categories (CVA)
A
Range from 0 (non functional) to 6 (independent)
Activity level measure
13
Q
What is the average score on Trunk Impairment Scale for non-ambulatory patients?
A
8
Average score for ambulatory patients is 14
Looks at static sitting balance, dynamic sitting balance, and coordination
Range from 0-23 (higher score better)
14
Q
Modified Ashworth Scale Grading Criteria
A
0- no increase in muscle tone
1- Catch and release at end of ROM
1+- Catch and minimal resistance through < 1/2 of ROM
2- Increased resistance through most of the ROM, affected parts easily moved
3- Passive movement difficult
4-Affected parts rigid in flexion or extension
15
Q
Does the MAS have high reliability or validity in CVA?
A
NOPE
16
Q
What are the cutoff gait speeds for household vs community ambulators?
A
<0.4 m/sec- household amb
0.4-0.8 m/sec- limited community
>0.8 m/sec- community
>1.2 m/sec- crossing streets and normal walking speed
<1.0 m/sec- need assistance
<0.6 m/sec- DEP in ADLs, more likely to be hospitalized
>1.0 m/sec- INDEP in ADLs, less likely to be hospitalized
17
Q
What are the 10MWT normative values for self-selected gait speed?
A
1.2-1.4 m/sec?
18
Q
What score on the BBS indicates greater likelihood of DC to home?
A
20/56
19
Q
Functional Reach cutoff score for fall risk
A
<6’’ or 15 cm
Activity level measure
20
Q
Postural Assessment Scale for Stroke (PASS)
A
Able to predict functional ability and DC destination better than trunk impairment scale
-Activity and BSF level
12 items
0-36 higher score is better
>12.5 ambulatory at DC
21
Q
What cutoff time on the TUG indicates increased risk for falls in CVA?
A
14 sec
22
Q
What cutoff time on the TUG indicates increased risk for falls in community dwelling adults?
A
13.5 sec
23
Q
Activity Specific Balance Confidence Scale cutoff score for risk in elderly adults
A
67%
Higher scores indicate increased confidence in one’s balance
24
Q
What is the ABC cutoff score for falls risk in patients with chronic stroke?
A
81%
25
What is a FIM score of 80-96 predictive of?
DC home
26
What range of FIM scores demonstrates higher gains with rehab?
37-72
Lowest score is 18, highest score is 126
27
Dynamic gait index cutoff score for fall risk (CVA)
<19
28
5x STS cutoff score for fall risk in CVA population
>12 sec
29
5xSTS cutoff score for fall risk in PD population
>16 sec
Floor effect in PD b/c patients can't stand w/ UEs
30
What is the key difference between the FIM and the Wolf Motor Function test?
Wolf Motor Function test takes into account quality of UE movement
Looks at use of the paretic UE in functional tasks
Scores range from 0-75, higher scores is better functioning
31
What is the normative values for 9 hole peg test?
```
20-30s- 17 sec
30s-40s- 18 sec
40-50s- 19 sec
50-60s-19- 21 sec
60-70s-21-22 sec
>75- 25 sec
```
32
What walking speed categories INDEP in ADLs?
>1.0 m/sec
33
What walking speed categorizes more likely to DC home?
>0.15 m/sec
34
What are the STREAM score categories for DC home?
Score of
<63- 0% DC home
63-95- 55% DC home
95-100- 86% DC home
Evaluation of motor function post stroke
35
What are Mini Mental State Exam Categories?
<24 cut off score
None 24-30
Mild 18-24
Severe 0-17
36
What is the Motor Activity Log?
Self rating of quality and amount of hemiparetic arm use
Activity level
Used in IP and OP rehab setting only
30 daily functional tasks
6 pt ordinal scale
0- not used at all
5-uses normally
Higher score=better quality of movement
out of 180 points?
37
What is the Action Research Arm Test?
Provides more information on grasp, grip, and pinch
Activity level measure
```
19 items
out of 57 points
0-cannot perform
3-Normal
Higher score=better functioning
```
38
What is the SIP-30?
```
Sickness Impact Profile
Assesses perceived health status
Self report
0-100%
Higher score= worse health status
```
39
What are the highly recommended outcome measures or AIS A/B?
- ASIA impairment scale
- World Health Organization Quality of Life-BREF
**Higher score better QOL (out of 130 points?)
5- best score
26 items?
40
What are the highly recommended outcome measures for AIS C/D?
- ASIA impairment scale
- 6MWT
- 10MWT
- TUG
- Walking Index for SCI II (WISCI II, not >6 months)
WISCI II
0- Unable
5- Parallel bars, braces, no assist, 10 m
8- walker, no braces, 1 person assist, 10 m
10- one cane/crutch, braces, 1 person assist, 10 m
13- walker, no braces, no assist, 10 m
15- one cane/crutch, no brace, 1 person assist
17- no device, no braces, 1 person assist
20- no device, no braces, no assist
41
What stage post injury is the Walking Index for SCI II recommended?
Acute <3 months
42
What stage post injury is the World Health Organization Quality of Life-BREF recommended?
Chronic >6 months
| Activity/participation level measure
43
What muscle strength in the quads indicates use of KAFO vs AFO?
```
<3= KAFO
>3= AFO
```
44
What are the mean TUG times for paraplegia and tetraplegia?
Paraplegia- 20 sec
| Tetraplegia- 15 sec
45
How is the WISCI II scored?
Score 0-20
0= unable to stand/participate in walking
20= amb with no AD or assist
Less responsive for higher functioning individuals
Gives more information on bracing and ADs
Activity level measure
46
What is the SCIM?
Spinal cord independence measure
Similar to FIM
Out of 100 points
Activity level measure
47
What is the SCI FAI
SCI Functional Ambulation Inventory
Looks at 3 domains of walking function
1. gait parameters
2. Assistive device
3. Temporal distance
Activity level measure
0-39
Higher score=higher level of function
48
What is the WUSPI?
Wheelchair users shoulder pain index
Score ranges 0-150
15 items
higher scores=greater pain
49
What does a high score on the WUSPI indicate?
Increased shoulder pain with activity
50
What MMT scores indicate use of specific strength testing measures?
>3/5 use handheld myometry
| <2+/5, use MMT
51
What time period post injury has the 6MWT shown the greatest responsiveness?
3-6 months post injury
52
What are the highly recommended outcome measures in the acute care setting for TBI?
Coma Recovery Scale
Agitated Behavior Scale
Rancho Levels of Cognitive Functioning
Moss Attention Rating Scale
53
What are the highly recommended outcome measures in the inpatient setting for TBI?
CRS
| MARS
54
What are the highly recommended outcome measures in the outpatient setting according to TBIEDGE task force?
6MWT
| Functional Assessment Measure
55
Based on the Coma Recovery Scale, what indicates emergence from minimally conscious state? CRS is also known as the JFK Coma Scale
Motor score of 6 or communication score of 2
Can help distinguish vegetative and minimally conscious state as well as determine emergence from minimally conscious state
56
What Rancho Levels is the CRS appropriate for?
Rancho levels I-IV
57
What is the range of scores on the CRS?
0-23
| Lower scores= reflexive and brainstem level activity
58
What are normative data for 6MWT from 60-90 year olds for healthier age matched controls?
400-600 m
| 1350-1900 ft
59
Disability Rating Scale scoring
0-30
| higher scores= more disability
60
What is the cutoff score for the Functional Assessment Measure?
FAM score <65 indicative of risk for long-term unemployment
Rated on same 7 point scale
Items are more functional
Activity level measure
61
What is the range of scores for ABS?
```
14-56
<21- WNL
22-28- mild
29-35- moderate
>35- severely agitated
```
62
What is the cutoff score on the ABS that indicates presence of agitation?
>22
63
Dizziness Handicap Inventory
0-100%
| Higher score=more disability
64
What specific 2 measures from the CRS are seen as demonstrating emerging MCS?
1. Functional object use
| 2. Functional/accurate communication
65
Glasgow Coma Scale
13-15- mild TBI
9-12- mod TBI
<8- severe TBI
<3- Vegetative state
66
What are the 3 categories scored on the GCS?
1. Motor
2. Eye opening
3. Verbal response
67
How is eye opening scored on the GCS?
4. Open spontaneously
3. Open to speech
2. Open to pain
1. Does not open
68
How is verbal response scored on the GCS?
5. Alert and oriented
4. Confused yet coherent speech
3. Inappropriate words and jumbled phrases of words
2. Incomprehensible sounds
1. No sounds
69
How it the motor response on the GCS scored?
6. Obeys commands fully
5. Localizes to noxious stimuli
4. Withdraws from noxious stimuli
3. Decorticate posturing
2. Decerebrate posturing
1. No movement
70
What are the highly recommended outcome measures in PD?
Body Structure and Function
1. MDS-UPDRS part 1 and 3
2. MOCA
Activity
1. 6MWT
2. 10MWT
3. Mini Best
4. MDS-UPDRS part 2
5. FGA
6. 5xSTS
Participation
1. PDQ 8 or 39
71
What is the cutoff score for risk of falling in PD on 5xSTS?
>16 sec
72
What is the 5xSTS norms for 60-90 year olds?
11-15 sec
73
What is the only validated measure of freezing of gait?
Freezing of gait questionnaire
Higher scores= greater severity of FOG
self report measure
completed during "on" medication time
scored 0-24; higher scores more severe
74
ABC cutoff scores for PD
```
<67%= risk of falling
<69%= predictive of recurrent falls
```
75
What is cognitive and motor dual task that can be combined with the TUG?
Cognitive- counting backwards by 3s from number between 20-100
Motor- carrying a cup of water
76
What is the TUG norm in healthy older adults compared to PD?
10 sec
77
The TUG is recommended for what stages of PD?
H+Y 1-4
78
MDS-UPDRS
```
Measure of burden and extent of PD, disease severity
Part 1- Mentation, Behavior, and Mood
Part 2- Assessment of ADLs
Part 3- Motor exam
Part 4- Motor complications
```
Higher score= greater disability
79
What is the mean score on the MDS-UPDRS in the PD population?
68
| highest score is 108
80
Montreal Cognitive Assessment (MoCa) cutoff scores
<26/30 Mild cog deficit
Cutoff score for PD-Dementia- 22/30
81
Mini best Test
Cut off score for prospective fallers 16/32
| Assessment of dynamic balance
82
FGA cutoff score to identify fallers in PD population
15/30
83
Normative date for FGA score for healthy adults
24-28/30
84
What is the cut off score for fall risk in PD on the BBS?
No specific established cut off score in the PD population
85
The BERG is recommended for what stages of PD?
H+Y Stage II-III
86
PDQ 9 or PDQ 39
Lower score=better QOL
| Participation levels
87
What score reflects improved QOL on PDQ-39 or PDQ-8?
Lower scores reflect better QOL
88
ALS-FRS (Functional rating scale)
Higher score, better functioning
| Out of 40 points total
89
Unified Huntington Disease Rating Scale (UHDRS)
Higher score= worse functioning
90
What is the cutoff score for increase fall risk in HD on the Berg?
40/56
91
What are the highly recommended outcome measures for MS population?
```
6MWT
MSWS-12 (for EDSS up to 7.5)
DHI (OP only)
MS Functional Composite (OP only)
MS QOL
MSIS-29
```
92
What type of measure is the MSWS-12? MS walking scale
```
Self reported measure of impact of MS on walking ability
Higher score is worse functioning
Score 1-5
5= extremely limited
Activity level measure
out of 60 points?
```
93
What was the average score on the MSWS-12 for fallers?
Score of 75/100
94
What comprises the MS Functional Composite?
1. Timed 25-foot walk test
2. 9 Hole peg test
3. Paced Auditory Serial Addition test
Only in OP setting
BSF/Activity level
95
MSQOL-54
Contains items from the SF 36 with 18 new items added
Activity and participation level
self report
Higher score= improved QOL
0-100
96
What is the normative value for the 6MWT in MS?
385 m (1260 ft)
97
What is normative values for healthy male adults between 60 to 80 on 6MWT?
400-600 m (1360 ft)
98
What is the cutoff score on the ABC to discriminate fallers?
<67%
99
Wha is the cutoff score on the DHI
<59%
| Well researched in OUTPATIENT setting for MS
100
What score on the DGI is indicative of fall risk in MS?
<12/24 points
MCID-2 points
101
What is the purpose of the EDSS?
Scale of disease severity in MS, NOT to be used as an outcome measure
102
Expanded Disability Status Scale (EDSS) scoring
1. No disability, minimal signs
2. Minimal disability
3. Moderate disability
4. Ambulatory without aid or rest 500 m
5. Ambulatory without aid or rest 200 m
6. Intermittent or unilateral constant assistance required for 100 m
6. 5- Constant bilateral assistance
7. unable to ambulate 5 meters with aid, wheels self in WC, transfers alone
8. restricted to WC , OOB most of day
9. Helpless in bed, can communicate and eat
10. Death d/t MS
103
Fatigue Scale for Motor and Cognitive Functions
| FSMC
Higher score means what?
Recommended in all treatment settings
104
MSIS-29
Self report measure asking impact of MS on day to day life
Score of 1= not at all
Score of 5= extremely
Higher score= worse function
max score of 100
Participation level measure
105
What are the normative values for the Box and blocks test?
Range from 83-61
83 blocks for people in their 40s
61 blocks for people in their 70s
106
What are the 5xSTS cutoff scores in MS?
```
<20 = INDEP for basic transfers
<30= DEP on transfers, do not go out alone
```
107
What is the cutoff score for fall risk on the 5xSTS in the vestibular population?
15 sec
108
What are the cutoff scores for the DHI? Vestibular population
Mild: 0-30
Moderate: 31-60
Severe: 61-100
109
What is the cutoff score for fall risk on the miniBEST for vestibular population?
<19 = recurrent fallers
110
What is the cutoff score for balance impairments in vestibular dysfunction on the BERG?
<45
111
What is the cutoff for fall risk on the FSST for vestibular population?
What is FSST?
>12 sec
112
What is the cutoff for fall risk on the DGI for vestibular population?
<19/24
113
What is the cutoff for fall risk on the FGA for vestibular population?
22/30
| 15/30 in the PD population
114
What is the cutoff for fall risk on the TUG in vestibular population?
>11 sec
115
What is considered a positive result on the Dynamic Visual Acuity test/
>2 lines ??
| measure of VOR function
116
What is considered a positive result on the Head impulse test?
Hypo/hyper metric corrective saccades
Hypo- peripheral hypofunction
Hyper- central
Measure of VOR function
117
When to use Frenzel lenses?
In peripheral lesion, person can suppress nystagmus in room light after 1 month
118
What is the cut off for fall risk in the ABC for vestibular population?
<67%
119
CISTB for vestibular conditions
Clinical version of the Sensory Organization Test
1. firm surface, EO
2. Firm surface, EC
3. firm surface, dome
4. foam surface, EO
5. foam surface, EC,
6. foam surface, dome
120
What are 2 screening tests done in infants until 12 months of developmental delays?
Albert Infant Motor Scale (AIMS)
| Harris Infant Neuromotor Test (HINTS)
121
What age is the TIMP used for?
Infants <4 months old
Test of infant motor performance
122
What ages is the Peabody Developmental Motor Scales used for?
0-7 years old
123
What measure assesses motor milestones through adulthood?
BOT 2
| Ages 4-21
124
What is the PEDI?
Pediatric evaluation of disability
| Detect functional limitations and disability in age appropriate independence
125
What population is the GMFM used for?
CP
126
What are confidence intervals?
Range of values; probability that the value of a parameter lies within it. EX. Sample mean 0.32 w/ SD of +/- 0.09. 95% confident that tread depth is between 0.25 and 0.384
127
What is effect size?
Magnitude of an intervention reflected by an index value; indep of sample size. Calculates the power of a relationship between 2 variables. How much percentage of the population falls under than percentage.
128
What is efficacy?
Performance of an intervention under ideal and controlled circumstances?
129
What is a false negative?
A test result which incorrectly indicates that a particular condition is absent
130
What is a false positive?
A test result which incorrectly indicates that a particular condition is present.
131
What is a P-value?
Chance that your result could be due to chance; closer to 0 you are more confident they are difference
132
What is reliability?
Result of a measurement can be depended on to be precise; overall consistency of a measure; high reliability if produces similar results under consistent conditions
133
What is validity?
The instrument measures what is was designed to measure
134
What is nominal data?
2 categories; no ranking relationship; ex boy or girl; yes or no
135
What is ordinal data?
Has order but no rank; ex. agree, strongly agree
136
What is interval data?
Has order and rank; ex. 1-4, 5-8, 9-12
137
What is ratio data?
Has rank, order, and countable (weight, temp, or age)
138
What are different analysis types?
Parametric- data is normally distributed; test group means
Non parametric- test group medians, can be used with smaller sample sizes
139
What is sensitivity vs. specificity
Sensitivity- The % of P's who have the disease that test positive; high sensitivity= few false negatives
Specificity- the % of P's who do not have the disease who test negative
140
What is the Positive Likelihood ratio?
The probability of a P w/ the disease and a positive test divided by probability of a P without the disease and a positive test
The higher the value, the more likely the patient has the condition. As an example, let's say a positive test result has an LR of 9.2. This result is 9.2 times more likely to happen in a patient with the condition than it would in a patient without the condition
141
What is the Negative Likelihood ratio?
The probability of a person with disease testing negative divided by probability of a person without the disease testing negative
Negative LR: This tells you how much to decrease the probability of having a disease, given a negative test result.
```
Values between 0 and 1 decrease the probability of disease (−LR)
0.1 −45% Large decrease
0.2 −30% Moderate decrease
0.5 −15% Slight decrease
1 −0% None
Values greater than 1 increase the probability of disease (+LR)
1 +0% None
2 +15% Slight increase
5 +30% Moderate increase
10 +45% Large increase
```
142
What is the effect size?
Indep of a sample size. Odds ratio- odds that an outcome will occur given a particular exposure compared to odds of the outcome occurring in the absence of that exposure
Values>1= stronger in favor
143
What is the Scale for Assessment and Rating of Ataxia?
0- no ataxia
| 40-severe ataxia
