TBI and GCS Scale

Level I (Rancho Los Amigos)

no response

Level I (Rancho Los Amigos) Description

total assistance

Level II (Rancho Los Amigos)

generalized response

Level II (Rancho Los Amigos) Description

total assistance

inconsistent and nonpurposeful response to stimuli

responses may be psychological changes, gross body movements or vocalizations

Level III (Rancho Los Amigos)

Localized Response

Level III (Rancho Los Amigos) Description

total assistance

specific but inconsistent responses realted to types of stimuli presented

able to follow simple commands such as eye closing or squeezing hand

Level IV (Rancho Los Amigos)

confused and agitated

Level IV (Rancho Los Amigos) Description

maximum assistance

heightened state of activity with bizarre non purposeful behavior

unable to distinguish between people and objects

unable to cooperate directly with treatment

verbalization are incoherent and confabulatory

gross attention is limited

lack short and long term recall

Level V (Rancho Los Amigos)

confused, inappropriate

Level V (Rancho Los Amigos) Description

maximum assistance

responses to simple commands fairly consistently

if commands are complex, responses are nonpurposeful or random

highly distractable

verbalization is inappropriate and confabulatory

inappropriate use of objects

able to perform previously leaned tasks with structure

Level VI (Rancho Los Amigos)

confused, appropriate

Level VI (Rancho Los Amigos) Description

moderate assistance

goal directed behavior depending on external input or directions

follow simple directions and shows carryover

responses are inappropriate but may be incorrect due to memory

past memory better than recent

Level VII (Rancho Los Amigos)

automatic appropriate

Level VII (Rancho Los Amigos) Description

minimal assistance

appropriate and oriented response

goes through daily routine automatically but robotlike

shows carryover for learning

needs structure for social activities

judgement is impaired

Level VIII (Rancho Los Amigos)

purposeful, appropriate

Level VIII (Rancho Los Amigos) Description

standby assistance

oriented

recalls and integrates past events

completes familiar tasks

over or underestimates abilities

shows a decreased ability compared to premorbid state in terms of abstract reasoning, stress tolerance and judgement

Brunnstrom Stages of Recovery 1

no spasticity, flaccid

no synergy

Brunnstrom Stages of Recovery 2

spasticity beginning

synergy appears, weak associated movements

Brunnstrom Stages of Recovery 3

peak spasticity

start to perform synergy voluntarily, mass synergy movement patterns

Brunnstrom Stages of Recovery 4

spasticity decreasing

begin out of synergy movements

Brunnstrom Stages of Recovery 5

spasticity decreasing

independent out of synergy movements, nearly free of synergy

Brunnstrom Stages of Recovery 6

minimal spasticity except during rapid movements

free of synergy, awkward isolated joint movements with coordination

Brunnstrom Stages of Recovery 7

normal, no spasticity

no synergy

Hoehn and Yahr Scale (PD) 0

no visible symptoms of parkinson disease

Hoehn and Yahr Scale (PD) 1

symptoms on only one side

Hoehn and Yahr Scale (PD) 2

symptoms on both sides of body and no difficulty walking

Hoehn and Yahr Scale (PD) 3

symptoms on both sides of body and minimal difficulty walking

begin to fall more often

Hoehn and Yahr Scale (PD) 4

symptoms on both sides of body and moderate difficulty walking

start using assistive devices

Hoehn and Yahr Scale (PD) 5

symptoms on both sides of body

unable to walk

eyes open spontaneously

4

eyes open to verbal command

3

eyes open to pain

2

no eye opening

1

oriented verbal response

5

confused but able to verbally answer question

4

inappropriate verbal response

3

incomprehensible sounds

2

no verbal response

1

obeys commands

6

localizes pain

5

withdrawal from pain

4

flexion to pain

3

extension to pain

2

no motor response

1

glascow coma scale score 13-15

mild

glascow coma scale score 12-9

moderate

glasgow coma scale <8

severe

spasticity scale 0

no increase muscle tone

spasticity scale 1

catch and release

slight increase in tone

minimal resistance at end of ROM

spasticity scale 1+

slight increase in tone

minimal resistance in less than half of ROM

spasticity scale 2

more marked increase in tone throughout ROM

affected part moves easily

spasticity scale 3

considerable increase in tone

PROM difficult

spasticity scale 4

affected part rigid in flexion and extension