Standardized tests of motor function

Question 1

What are the three components of motor function

Answer 1

• patient history
• review of relevant systems
• specific tests and measures that allow formulation of the diagnosis, prognosis, and plan of care

Question 2

What are some tests of motor function

Answer 2

• the barthel index
• rivermead mobility index
• fugl-meyer assessment- motor preformance
• stroke rehabilitation assessment of movement (STREAM)
• action research arm test (ARAT)
• high level mobility assessment tool (HiMAT)
• functional independence measure (FIM)
• Inpatient rehabiliation facility patietn assessment instrument (IRF-PAI)

Question 3

The barthel index

Answer 3

• developed by a PT over 40 years ago
• assesses ability of an individual with a neuromuscular or musculoskeletal disorder to care for him/herself
• 10 ADL/mobility activities, graded on an ordinal scale

Question 4

The barthel index scoring

Answer 4

• items are rated based on the amount of assistance required to complete each activity
• levels of measurement are limited to complete independence of needing assistance
• total score rnages from 0-100

Question 5

rivermead mobility index

Answer 5

• assesses functional mobility following a stroke
• 15 items
• 14 self-reported items
• 1 direct observation
• items progress in difficulty
• 3 tries allowed for each item

Scoring: 0=cannot 1= can

Question 6

Fugl-meyer assessment

Answer 6

• measures motor recovery in poststroke hemiplegic patients
• fulle FMA includes 226 items across five domains: UE motor LE motor, balance, sensation, joint ROM nad joint pain
• items are scored using a 3 point ordinal scale where 0= cannot perform and 1 = patient performs partially and 2 = performs fully
• motor scores ranges from 0 (hemiplegia) to 100 (normal) points with 66 points for UE and 34 points for LE
• motor scores predictive of LOS in rehab; LE motor score predictive of level of mobility @d/c

Question 7

Stroke Rehab Assessment of Movement (STREAM)

Answer 7

• 10 UE + 10 LE items compare quality and excursion of movement between involved and uninvolved sides
• 10 basic mobiltiy items assess transfer, standing, and ambulation
• each item scored on 3-point ordinal scale
• max score for total = 70 points
• predictive of gait speed, functional mobility and D/C destination after acute care

Question 8

Action reseach arm test (ARAT

Answer 8

• 19 UE functional tasks/movements with four subscales: grasping, gripping, pinching and gross movement
• ordinal scale where 0 = no movement and 3 = normal movement
• total score ranges from 0-57
• responsive to change but floor effects early after stroke and ceiling effects in subacute
• MCID if dominant affect = 17 points

Question 9

HIgh level mobility assessment tool (HiMAT)

Answer 9

• designed to assess high-level motor preformance in TBI patients
• minimum mobility requirement is independent walking for 20 m without gait aids
• orthoses are permitted
• 20 items assess a wide range of high-level activity

must be able to walk

Question 10

HiMATscoring

Answer 10

• each item is assessed on 5-6 point scale
• total score = sum of scores obtained on all items successfully attmpted by patient
• maxium score for th HiMAT is 54

Question 11

Functional independence measure (FIM TM )

Answer 11

• developed to resolve long-standing problem of lack of uniform measurment and data on disabilty and rehab outcomes
• measures level of a patietn’s disability and how much assistance is required to carry out ADLs

Question 12

FIM properties

Answer 12

• 18-item ordinal scale
• 13 motor tasks +5 cognitive tasks
• used with all diagnoses within a rehab population
• scores for each item range from 1-7

Question 13

FIM

scoring

Answer 13

• 7 = completely independence
• 1= total assist (performs < 25%)
• < 6 requires another person for supervision or assistance
• score ranges from 18 to 126 indicating level of function
• rated at admission and discharge

Question 14

Inpatient rehab facility patient assessment instrument (IRF-PAI)

Answer 14

• the data collected for IRF-PAI:
• measures the functional ability of a patient
• measures quality of care
• determines the payment for each medicare part A fee-for service patient
• determines length of stay
• prior level of function and devices used are important to note