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Measurement instrument for evaluating joint range of motion; accuracy is ensured through following standardized procedures including:
• client position
• positioning of the instrument

Goniometer

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Normal range of motion for the cervical spine

Degrees of measurement include:
• flexion: 0-45
• extension: 0-45
• lateral flexion: 0-45
• rotation: 0-60

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Normal range of motion for the thoracic and lumbar spine

Degrees of measurement include:
• flexion: 0-80
• extension: 0-30
• lateral flexion: 0-40
• rotation: 0-45

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Normal range of motion for the shoulder

Degrees of measurement include:
• flexion: 0-170
• extension: 0-60
• horizontal abduction: 0-40
• horizontal adduction: 0-130
• internal rotation: 0-70
• external rotation: 0-90

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Normal range of motion for the elbow and forearm

Degrees of measurement include:
• flexion: 0 to 135-150
• supination: 0 to 80-90
• pronation: 0 to 80-90

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Normal range of motion for the wrist

Degrees of measurement include:
• flexion: 0-80
• extension: 0-70
• ulnar deviation: 0-30
• radial deviation: 0-20

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Normal range of motion for the thumb

Degrees of measurement include:
• MP flexion: 0-90
• IP flexion: 0 to 80-90
• abduction: 0-50

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Normal range of motion for fingers

Degrees of measurement include:
• MP flexion: 0-90
• MP hyperextension: 0 to 15-45
• PIP flexion: 0-110
• DIP flexion: 0-80
• abduction: 0-25

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Normal range of motion for the hip

Degrees of measurement include:
• flexion: 0-120
• extension: 0-30
• abduction: 0-40
• adduction: 0-35
• internal rotation: 0-45
• external rotation: 0-45

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Normal range of motion for the knee

Degree of measurement include:

• flexion: 0-135

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Normal range of motion for the ankle and foot

Degrees of measurement include:
• plantar flexion: 0-50
• dorsiflexion: 0-15
• inversion: 0-35
• eversion: 0-20

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Structured approach to measure muscle strength and apply a muscle grade to the maximal effort put forth

Grading scale range: Zero (0/5) to Normal (5/5)

Manual muscle testing

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Muscle grade assigned for:
• no active movement noted
• no muscle contraction observed or palpated

Muscle grade 0/5

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Muscle grade assigned for:
• trace movement observed and palpated
• no active movement noted, but muscle contraction is observed or palpated

Muscle grade 1/5

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Muscle grade assigned for:
• poor strength observed where movement is noted only in a gravity-minimized plane

Score may range from:
• ___ (-): able to initiate movement in gravity-minimized plane
• ___: incomplete ROM in gravity-minimized plane
• ___ (+): complete ROM in gravity-minimized plane

Muscle grade 2/5

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Muscle grade assigned for:
• fair strength observed where movement is noted against gravity

Score may range from:
• ___(-): incomplete ROM against gravity
• ___: full ROM against gravity with no resistance applied
• ___(+): full ROM against gravity and slight resistance

Muscle grade 3/5

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Muscle grade assigned for:

• good strength observed with full ROM against gravity and moderate resistance

Muscle Grade 4/5

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Muscle grade assigned for:

• normal strength observed with full ROM against gravity and maximal resistance

Muscle grade 5/5

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Level of assistance where a client needs >75% verbal or physical assistance to complete a task or is unable to perform any component of the task

Dependent

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Level of assistance where a client needs 50-75% verbal or physical assistance to complete a task

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Maximal assistance

Level of assistance where a client needs 25-50% verbal or physical assistance to complete a task

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Moderate assistance

Level of assistance where a client needs <25% verbal or physical assistance to complete a task

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Minimal assistance

Level of assistance where a client requires caregiver or practitioner assistance to be within arm’s reach to safely complete a task

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Stand-by assistance

Level of assistance where a client requires zero physical or verbal assistance to safely complete a task

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Independent

Level of assistance where a client requires occasional verbal assistance to safely complete a task

Supervised

Level of assistance where a client requires use of adaptive equipment or increased time to complete a task

Modified independence

American Spinal Cord Injury Association neurological classification system used to determine level of impairment to the spinal cord after an injury. Results are based on: • sensory testing of each dermatome for right and left sides • manual muscle testing for right and left sides

ASIA impairment scale (AIS)

Neurological classification for the level of impairment to the spinal cord after injury, characterized by: • complete lesion with no motor or sensory function preserved in the sacral segments S4-S5

ASIA impairment scale (AIS A)

Neurological classification for the level of impairment to the spinal cord after injury, characterized by: • incomplete lesion with sensory but no motor function preserved below the neurological level; includes the sacral segments S4-S5

ASIA impairment scale (AIS B)

Neurological classification for the level of impairment to the spinal cord after injury, characterized by: • incomplete lesion with motor function preserved below the neurological level • more than half of key muscles below the neurological level have a muscle grade less than 3 (fair)

ASIA impairment scale (AIS C)

Neurological classification for the level of impairment to the spinal cord after injury, characterized by: • incomplete lesion with motor function preserved below the neurological level • at least half of key muscles below the neurological level have a muscle grade of 3 (fair) or more strength

ASIA impairment scale (AIS D)

Neurological classification for the level of impairment to the spinal cord after injury, characterized by: • normal motor and sensory function

ASIA impairment scale (AIS E)

Classification for this level of recovery after a traumatic brain injury: No response: Total assistance Characterized by: • No change in behavior when presented with any form of stimuli

Rancho Los Amigos Level of Cognitive | Functioning: Level I

Classification for this level of recovery after a traumatic brain injury: Generalized response: Total assistance Characterized by: • generalized reflex response to painful stimuli • responses may be delayed • responds to repeated auditory stimuli with increased or decreased activity

Rancho Los Amigos Level of Cognitive | Functioning: Level II

Classification for this level of recovery after a traumatic brain injury: Localized response: Total assistance Characterized by: • response to discomfort by pulling tubes or drains • blinks when bright light crosses visual field • inconsistent response to simple commands

Rancho Los Amigos Level of Cognitive | Functioning: Level III

Classification for this level of recovery after a traumatic brain injury: Confused/agitated: Maximal assistance Characterized by: • alert and in a heightened state of activity • absent short-term memory • purposeful attempt to remove restraints or tubes • may exhibit aggressive behavior

Rancho Los Amigos Level of Cognitive | Functioning: Level IV

Classification for this level of recovery after a traumatic brain injury: Confused, inappropriate nonagitated: Maximal assistance Characterized by: • not oriented to person, place, or time • may wander • unable to learn new information • inappropriate use of objects without redirection

Rancho Los Amigos Level of Cognitive | Functioning: Level V

Classification for this level of recovery after a traumatic brain injury: Confused, appropriate: Moderate assistance Characterized by: • inconsistent orientation to person, place, and time • supervision needed for old learning (e.g. self-care tasks) • may attend to a familiar task in a distraction-free environment for up to 30 minutes with moderate redirection

Rancho Los Amigos Level of Cognitive | Functioning: Level VI

Classification for this level of recovery after a traumatic brain injury: Automatic, appropriate: Minimal assistance for daily living skills Characterized by: • minimal supervision for new learning • may attend to a familiar task in a distraction-free environment for up to 30 minutes with minimal redirection • overestimates abilities • minimal supervision for safety in home and community routines Classification for this level of recovery after a traumatic brain injury: Automatic, appropriate: Minimal assistance for daily living skills Characterized by: • minimal supervision for new learning • may attend to a familiar task in a distraction-free environment for up to 30 minutes with minimal redirection • overestimates abilities • minimal supervision for safety in home and community routines

Rancho Los Amigos Level of Cognitive | Functioning: Level VII

Classification for this level of recovery after a traumatic brain injury: Purposeful, appropriate: Stand-by assistance Characterized by: • stand-by assistance for daily living skills to take corrective action when impairments interfere with task completion • independently attends to and completes familiar tasks for one hour • independent once a new activity is learned

Rancho Los Amigos Level of Cognitive | Functioning: Level VIII

Classification for this level of recovery after a traumatic brain injury: Purposeful, appropriate: Stand-by assistance on request Characterized by: • stand-by assistance on request when impairments interfere with task completion • can shift between tasks and can attend for a minimum of 2 hours • uses assistive memory devices • able to monitor appropriateness of social interactions with stand-by assistance

Rancho Los Amigos Level of Cognitive | Functioning: Level IX

Classification for this level of recovery after a traumatic brain injury: Purposeful, appropriate: Modified independent Characterized by: • can independently handle multiple tasks simultaneously, but may require occasional breaks • accurately estimates skills and abilities and independently adjusts task demands • social behaviors are consistently appropriate

Rancho Los Amigos Level of Cognitive | Functioning: Level X

``` Allen Cognitive Level characterized by: • reflexive responses • responsive to internal stimuli • impaired awareness of time and place • global cognition impaired • maximum assistance for ADL ```

Allen Cognitive Level 1 | Automatic actions

``` Allen Cognitive Level characterized by: • awareness of gross motor movements • global cognition impaired • may benefit from 1-step verbal instructions • requires 24-hour nursing care ```

Allen Cognitive Level 2 | Postural actions

Allen Cognitive Level characterized by: • ability to manipulate objects with hands • responsive to tactile cues • repetitive actions that are not goal directed • short attention span and unpredictable behaviors

Allen Cognitive Level 3 | Manual actions

``` Allen Cognitive Level characterized by: • global cognition moderately impaired • responds to tangible, visual motor cues • some goal-directed behaviors • can pay attention for up to 1 hour ```

Allen Cognitive Level 4 | Goal-directed actions

Allen Cognitive Level characterized by: • global cognition mildly impaired • trial-and-error method used during activities • decreased ability to plan ahead and anticipate errors • poor judgement and occasionally impulsive

Allen Cognitive Level 5 | Exploratory actions

Allen Cognitive Level characterized by: • abstract thinking is intact • carry-over of learning from one session to another • anticipates errors and demonstrates ability to plan ahead • judgement and problem-solving is intact

Allen Cognitive Level 6 | Planned actions

Phys dys Flashcards

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