LAB 10: OCM & Sensory Testing

6MWT ICF domain

Activity

What does 6MWT measure

Submax aerobic capacity and endurance

MCID 6MWT chronic CVA

50 meters in chronic CVA

Can pt use AD/bracing in 6MWT

• Yes

  • Document use

10 MWT ICF domain

Activity

What does 10MWT measure

Gait speed

10 MWT MCID brain injury and subacute stroke

• Brain injury: regular 0.15 m/s; fast 0.25 m/s

• Subacute stroke: regular 0.16 m/s

6MWT and 10MWT level 1 assistance

Total assistance

• pt performs 0-24%

6MWT and 10MWT level 2 assistance

Max assist

• pt performs 25-49%

6MWT and 10MWT level 3 assistance

Mod assist

• pt performs 50-74%

6MWT and 10MWT level 4 assistance

Min assist

• pt performs 75-99%

6MWT and 10MWT level 5 assistance

Supervision

• Stand-by or set-up assistance; no physical contact provided

6MWT and 10MWT level 6 assistance

Modified independent

• Requires use of AD or bracing, needs extra time, mild safety issues

6MWT and 10MWT level 7 assistance

Independent

Berg balance scale ICF domain

Activity

What does berg balance scale measure

Static and dynamic balance

Berg balance scale for subacute stroke MCID

4 points

Activities-specific balance confidence scale (ABC scale) ICF domain

Activity and participation

What does ABC scale measure

Balance confidence

ABC scale for subacute stroke MCID

11-13%

On the ABC scale, at what level is there an increased risk for falls in CVA

< 81%

Functional gait assessment ICF domain

Activity

What does functional gait assessment measure

Gait stability

Functional gait assessment for subacute stroke MCID

5 points

Fall risk score functional gait assessment

< 23/30

5 time sit to stand ICF domain

Activity

What does 5 time sit to stand measure

• Leg strength

• Balance/fall risk

Fall risk cut off 5 time sit to stand (subacute stroke vs elderly)

• Subacute stroke: >12 sec

• Elderly: >14 sec

what population to use postural assessment scale for stroke

Acute/subacute populations (first 3 months post CVA and lower-level patients)

What does postural assessment scale for stroke predict

Ambulation at d/c

What does trunk impairment scale evaluate

Static and dynamic sitting balance and coordination of trunk movement

Subscales of trunk impairment scale

• Sitting balance

• Dynamic sitting balance

• Coordination

Tone evaluation measures

• Modified ashworth scale or tardieu

• Clonus evaluation

• PROM

Agitated behavior scale population and setting - why these settings

TBI acute/IPR

• Personality changes most frequently occur in those settings

What does agitated behavior scale measure

Disinhibition, ability to pay attention

What is agitated behavior scale good for determining

What environment is best and how to go about tx

• What stimuli are agitating or acceptable

When is HiMAT used

High level patients with brain injury

• ex) athlete who suffered BI

Min mobility requirement for HiMAT

20m without gait aids

Orthotics ________ be worn for HiMAT

Can
(but better without)

What population is the community and mobility balance scale good for

someone with balance deficits aiming for community ambulation

Detection sensory testing

Threshold stimulus

• Can you feel it

Discrimination sensory resting

ID of location

• Where do you feel it

Sharp v. dull tests what spinal tract?

Spinothalamic tract

Hot v. cold tests what spinal tract?

Spinothalamic

What patients might vibration testing be useful for

Those with peripheral neuropathy

What Hz tuning fork used for vibration

128-Hz

Frequency for meissner corpuscles

30 Hz

Frequnecy for pacinian corpsucles

256 Hz

Semmes-Weinsten monofilament use

Evaluate light touch and deep pressure

Within normal limits monofilament

2.83

Monofilament size for protective sensation in feet

5.07

Tactile localization

The ability to determine which portion of the skin has been touched

What do you record for two point discrimination

Smallest distance at which the patient can reliably differentiate between the application of one or two points

Graphesthesia

ID what you drew on hand

Stereognosis test

Identifying object with eyes closed

How long should it take to be able to ID object

Within 5 seconds of contact

3 methods for proprioception testing

1. Move limb and patient mirrors position with opposite limb

2. Move limb then reposition limb to start position and have patient repeat movement using same limb

3. Verbally describe limb movement

Joint position sense

Identify the following proprioceptive sensations test

• Test the ability to perceive joint position at rest in response to YOUR POSITIONING to patient's limb (up,down, in, out)

Joint movement sense

pt responds while you are passively moving the target joint