Neuro Skills Check Notes

These flashcards cover key concepts, terms, and definitions from the Neuro Skills Check lecture, useful for exam preparation.

Coordination testing: UE DTRs

Biceps: C5

Brachioradialis: C6

Triceps: C7

Coordination testing: LE DTRs

Patellar: L3-L4

Achilles: L5-S1

DTR Grading system

0 = absent

1 = sluggish

2 = normal

3 = exaggerated

4 = hyper-reflexive —> UMN lesion

After, check both sides!

Dr. Thomas = not going to have super noticeable reflexes

Dr. Greenhagen = mention side-to-side differences

DTR: Babinski’s

UMN lesion impacting the corticospinal tract

Dysmetria test

A condition where there is inaccuracy in the movement, testing cerebellar function.

Dysdiadochokinesia test

Inability to perform rapid alternating movements, often tested with hand movements.

Tone test: drop arm test

1. Stand on the side of the patient

2. Abduct the patient’s arm and pretend to check ROM or joint mobility

3. Drop the arm suddenly to determine tonicity

Tone test: pendulum test

1. Let the patient sit down

2. Extend the knee and pretend to check the ROM/joint mobility

3. Drop the leg suddenly to determine tonicity

Hypertonia

Increased muscle tone, often due to upper motor neuron lesions.

Hypotonia

Decreased muscle tone, commonly linked to lower motor neuron lesions.

Spasticity Testing

A reflexive condition where the muscle tone is velocity-dependent, being more pronounced with rapid movement.

Rigidity Testing

Testing muscle stiffness that is not velocity dependent, indicative of basal ganglia lesions.

Berg Balance Assessment: Parameters

A 14-item test used to measure balance (0-4), where scores below 45 indicate a higher fall risk. >40 indicating very high fall risk.

Berg Balance Assessment: Equipment

• Tape measure

• Tape

• Chair

• Step

• Stopwatch

• Item for picking up

Berg Balance Assessment: Activities

1. Sitting → standing

2. Standing - sitting

3. Standing unsupported

4. Sitting unsupported

5. Transfers

6. Standing w/ EC

7. Standing w/ feet together

8. Reaching forward w/ outstretched arm

9. Retrieving object from floor

10. Turning to look behind

11. Turning 360

12. Placing alt. foot on stool

13. Standing in tandem

14. Standing on one foot

Functional Gait Assessment: Parameters

A test consisting of 10 items used to measure gait and fall risk, with a cutoff score of 22/30 indicating increased risk. Grading 0-3 (3 = normal)

• 20 ft walkway marked w/ 12 in. width and set of stairs

Functional Gait Assessment: Activities

• Walk on flat surface

• Walk w/ horiz head turns

• Walk w/ vert head turns

• Change gait speed

• Gait and pivot turn

• Step over obstacle

10 Meter Walk Test

A functional mobility test to assess walking speed over a distance, with specific speed thresholds indicating capacity. Divide 6m by time

• Perform 2 trials: one being comfortable and one being fast

6 Minute Walk Test: Parameters

A test to measure endurance, indicating fall risk if <400 meters walked in 6 minutes. Good to use for COPD, SCI, stroke, Parkinson’s

6 Minute Walk Test: Equipment & Don’t forget!

Equipment: stopwatch, measuring wheel, 30-meter walkway, 2 cones to mark distance, pulse oximeter

• CHECK HR & SPO2 every minute

• Can have breaks as long as the person doesn’t sit down.

5 Times Sit to Stand Test

A measure of lower body strength and stability, where completion times above specific thresholds indicate fall risk.

Community Ambulator

An individual who walks at a speed greater than 0.80 m/s.

Limited community ambulator

0.4-0.8 m/s

Household ambulator

<0.4 m/s

10-meter walk test: ages

60-69: 1.24-1.34 m/s

70-79: 1.13-1.26 m/s

80-99: 0.94-0.97 m/s

Healthy older adult speed for 10 Meter Walk Test

<0.7 m/s

Equipment for 10 Meter Walk Test

Requires a flat, straight path of at least 10 meters and a stopwatch.

Equipment for 5 Times Sit to Stand Test

Requires a standard chair (about 18 in seat height) and a stopwatch.

5 Times Sit-stand: Cut off

>15 seconds = 74% risk of falls

5 Times Sit-stand: Cut off for 60-69

8.4m/12.7f

5 Times Sit-stand: Cut off for 70-79

11.6m/13.0f

5 Times Sit-stand: Cut off for 80-89

16.7m/17.2f