NMPT Skills Check 1 Scales

What is the grading scale for synergy testing?

Selective Movement: Isolated movement at a joint not obligated to any movement pattern

Selective with Patterned Overlay: Can move electively at a joint through at least 50% of the range before patterned movement occurs and/or moves selective at a joint except under conditions of high challenge (resistance or movement against gravity for example)

Deviating from Patterned Movement: Can initiate selective movement at a joint but then moves into pattern prior to moving through 50% of the range

Completely Patterned Movement: Completely in patterned synergy

Grading scale for Tone/Spasticity?

Modified Ashworth Scale

0: No increase in muscle tone

1: Slight increase in muscle tone, manifested by a catch and release or by minimal resistance at the end of the range of motion when the affected part(s) is moved in flexion or extension (or abduction and adduction, etc.)

1+: Slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder (less than half) of the range of motion

2: More marked increase in muscle tone through most of the range of motion, but affected part(s) easily moved

3: Considerable increase in muscle tone, passive movement difficult

4: Affected part(s) rigid in flexion or extension (or abduction and adduction, etc.)

Grading Scale for Coordination (dysmetria and dysdiadochokinesia)?

Normal: Accurate return to starting position

Minimal Impairment: Able to accomplish activity; slightly less than normal control, speed, and steadiness

Moderate Impairment: Able to accomplish activity; movements are slow, awkward and unsteady

Severe Impairment: Only able to initiate activity without completion; movements are slow with significant unsteadiness, oscillations and/or extraneous movements

Unable: Inability to initiate activity

Grading for Sharp/Dull (pain) testing?

Normal: Intact (5/5 correct) Pt. does distinguish between sharp and dull without hesitation and reports it is the same intensity as that on an intact area of the body

Impaired: Impaired (3-4/5 correct) OR with 5/5 correct reports the feeling is different than that of the intact area of the body (intensity may be lesser or greater than normal)

Absent: Absent (0-2/5 correct) OR pt. does not distinguish between the sharp and dull ends of the testing tool or pt. has no feeling of being touched

Grading for Light Touch?

0/5: Absent

1-2/5: Severely Impaired

3/5: Moderately Impaired

4/5: Minimally Impaired

5/5: Intact

Grading for Proprioception and Kinesthesia?

Normal: Intact (5/5 correct)

Impaired: Impaired (1-4/5 correct)

Absent: Absent (0/5 correct)

Grading for Visual Field Testing?

Negative Test: Ability to see finger in all 4 quadrants

Positive Test: Monocular visual loss (visual field deficits)

Grading for Extraocular Movements?

Negative Test: Normal eye movement and absence of nystagmus or strabismus

Positive Test: Presence of 2 or more saccades, strabismus, impaired eye movements, or diplopia

CN III: Positive test is weakness of upward, downward, or inward movements and/or strabismus (eye turned outward)

CN IV: Positive test is weakness of downward or torsional movements of the eye

CN VI: Positive test is esotropia (eye turned in at rest) and lack of complete lateral eye movements

Grading for Static Sitting balance?

Unable (U): Unable to sit unsupported

Poor (P): Able to sit unsupported up to 10 seconds

Fair (F): Able to sit unsupported for more than or equal to 30 seconds

Good (G): Able to maintain balance when challenged by minimal resistance

Normal (N): Able to maintain balance when challenged by strong resistance

Grading for Dynamic Sitting Balance?

Unable (U): Unable to sit unsupported

Poor (P): Unable to shift trunk from midline without losing balance

Fair (F): Able to shift trunk from midline in all directions through less than 50% of the full range of motion

Good (G): Able to shift trunk from midline in all directions through greater than or equal to 50% of the full range of motion

Normal (N): Able to shift trunk from midline in all directions through through the full range of motion

Grading for static standing balance?

Unable (U): Unable to stand unsupported

Poor (P): Able to stand unsupported up to 10 seconds

Fair (F): Able to stand unsupported for more than or equal to 30 seconds

Good (G): Able to maintain balance when challenged by minimal resistance

Normal (N): Able to maintain balance when challenged by strong resistance

Grading for dynamic standing balance?

Unable (U): Unable to stand unsupported

Poor (P): Unable to shift trunk from midline without losing balance

Fair (F): Able to shift trunk from midline in all directions through less than 50% of the full range of motion

Good (G): Able to shift trunk from midline in all directions through greater than or equal to 50% of the full range of motion

Normal (N): Able to shift trunk from midline in all directions through through the full range of motion