Comprehensive Tests & Measures in Physical Therapy: Balance, Vital Signs, and ROM

Purpose of Tests & Measures

Establish baseline @ initial evaluation (TUG, BERG Balance, 6 min walk, standard balance battery), track progress, guide treatment

Validity

Does the test measure what it should?

Reliability

Consistent results across testers/time

Intra Reliability

Within tester (mistakes)

Inter Reliability

Between testers (mistakes)

Standardization

Using the same method for accuracy

Heart Rate (HR)

60-100 bpm

Respiratory Rate (RR)

12-18 breaths/min

Blood Pressure (BP)

90/60 - 120/80 mmHg (above 120/80 is prehypertension)

Oxygen Saturation (SpO2)

95-100%

Temperature

97-99 degrees F (37 degrees C avg)

BP PROCESS

1. Pulse (Brachial) 2. Line Cuff Up w/ brachial 3. Stethoscope Bell on artery 4. Pump it up >180 mm/Hg 5. Deflate it (Rate is an art)

Timed Up & Go (TUG)

<12 sec normal, >13.5 fall risk, 12

Berg Balance Scale (BBS)

0-56; <45 = Fall Risk

6-Minute Walk

500(1640ft)-700m (2300ft) typical adult; declines with age

Gait Speed

1.0-1.4 m/s; <0.8 m/s = risk

Manual Muscle Testing (MMT)

0-5 scale (poor intra+inter reliability)

Standard Balance Test

Not for geriatrics; Can show which side is weaker or stronger; Stand for 30 seconds on both legs eyes open/closed; On one right/left leg eyes closed/open; Left/Right foot in front eyes closed/open

30s Sit to Stand

Measures lower body strength, functional mobility, and risks of falling

Average Score for 30s Sit to Stand by Age and Gender

60-64 Men <14, Women <12; 65-69 Men <12, Women <11; 70-74 Men <12, Women <10; 75-79 Men <11, Women <10; 80-84 Men <10, Women <9; 85-89 Men <8, Women <8

Fall Risk Assessment

Any score below the average for that age group and gender is considered fall risk.

Mytomes

Key muscle groups by spinal level

Dermatomes

Skin sensation regions

Reflexes

normal, hypo, or hyperactive

Range of Motion (ROM) checks

Assessment of joint movement capabilities.

Strength Quick Checks

Brief assessments of muscle strength.

EOC

8 weeks

Reassess

4 weeks

Initial Evaluation

The first assessment of a patient's condition.

Diagnosis

Identification of a disease or condition.

Physical Limitations

Restrictions in physical capabilities.

Assess: Qual/Quan

Evaluation of qualitative and quantitative aspects.

ROM (goniometer)

Measurement of joint angles using a goniometer.

Strength (MMT)

Muscle strength assessment using Manual Muscle Testing.

Balance (30s balance)

Assessment of balance over a 30-second period.

Functional Outcomes

Results related to a patient's ability to perform daily activities.

Pt: Walking, transfers

Patient's ability to walk and transfer (6m WT, Gait Speed).

Ot: ADL's

Occupational therapy assessments of Activities of Daily Living.

Both: Fall Risk

Assessment of risk of falling (TUG, Berg BT).

OIAN (Origin Insertion Action Nerve)

A method to describe muscles' anatomy and function.

Shoulder Flexion

0 - 180 degrees of shoulder movement.

Shoulder Extension

0 - 60 degrees of shoulder movement.

Shoulder Abduction

0 - 180 degrees of shoulder movement.

Shoulder Internal Rotation

0 - 70 degrees of shoulder movement.

Shoulder External Rotation

0 - 90 degrees of shoulder movement.

Cervical Spine Flexion

0 - 45 degrees of neck movement.

Cervical Spine Extension

0 - 45 degrees of neck movement.

Cervical Spine Lateral Flexion

0 - 45 degrees of neck movement.

Cervical Spine Rotation

0 - 60 degrees of neck movement.

Hip Flexion

0 - 120 degrees of hip movement.

Hip Extension

0 - 30 degrees of hip movement.

Hip Abduction

0 - 45 degrees of hip movement.

Hip Adduction

0 - 30 degrees of hip movement.

Hip Internal Rotation

0 - 45 degrees of hip movement.

Hip External Rotation

0 - 45 degrees of hip movement.

Knee Flexion

0 - 135 degrees of knee movement.

Knee Extension

0 degrees (neutral) of knee movement.

Knee Hyperextension

Up to 10 degrees in some individuals.