EXAM 1 Outcome Measures to Know

mCTSIB

stands for Modified Clinical Test of Sensory Interaction in Balance. It assesses a person's ability to maintain balance under various sensory conditions, providing insights into balance dysfunction

what are the cut off scores for the mCTSIB?

30 seconds in each category typically means normal balance and reliance on each system (whole thing scored out of 120 since there are 4 conditions)

FIST (Function In Sitting Test)

examines the ability to maintain sitting balance during static sitting with eyes open and closed and during dynamic challenges to balance. Helps to assess reactive and anticipatory balance, useful on acute stroke pts, good for pts with low tolerance or with acute or chronic vestibular dysfunction

what is the cut-off score for the FIST?

less than 42/56

FSST (Four step square test)

used to assess pts who have difficulty stepping over obstacles and in varied directions (is not very good for ppl with cognitive impairments though since complex). helps to assess dynamic balance and moving in different directions, highly recommended for use in acute and chronic vestibular dysfunction

cut-off score for the FSST

greater than 15 seconds

TUG

measures a person's mobility and requires both static and dynamic balance. It involves timing a person as they stand up from a chair, walk three meters, turn around, walk back, and sit down. doesn’t really assess gait speed though

cut-off score for the TUG and TUG cognitive

greater than 13.5 for community dwelling adults, 15 seconds for the cognitive

BBS/berg balance scale

comprehensive balance exam appropriate for assessing balance in the older adult in a clinical setting, 14 item exam that measures various aspects of balance, including static and dynamic stability in sitting and standing. It provides a total score ranging from 0 to 56, with higher scores indicating better balance. (no gait items)

cut-off score for the berg balance scale

48-56 low fall risk, 40-47 medium fall risk, 39 or less high fall risk (less than 44 increase likelihood of multiple falls)

10 MWT (10 meter walk test)

a measure of walking speed, assessing the time it takes for an individual to walk 10 meters at a comfortable pace. It is used to evaluate mobility and can help identify individuals at risk for falls. (speed is calculated during the 6 m in the middle to not include acceleration or deceleration phase)

cut-off scores for 10 M walk tests

• less than 0.4 m/s indicates household ambulator (limited mobility, usually indoors only)

• 0.4-0.8 m/s limited community ambulator (can walk short community distanced but decreased endurance)

• greater than 0.8 m/s community ambulator

• greater than 1.0 m/s typical community ambulator, predictive of independence

• greater than 1.2 m/s benchmark for safe community ambulation, safely cross streets

what gait speed is associated with higher fall risk?

less than 0.7 m/s

activities specific balance confidence scale

self report questionnaire of confidence in maintaining balance during 16 everyday activities, captures perceived balance confidence/fear of falling, which influences participation

cut off score for the ABC scale

A score less than 67%

6 minute walk test

measures walking endurance over 6 mins, assess CV endurance and community ambulation capacity

cut off score for 6 minute walk test

for healthy adults

• men: 580-700 m

• women: 500-600 m

5x STS

evaluates functional LE strength and transitional movement control. screens for fall risk, mobility deficits, and ability to perform transfers independently

cut off score for the 5 STS

for older adults, a score above 12 seconds is associated with higher fall risk.

which outcome measures are part of the core ANPT core outcome measures

• Berg Balance Scale

• FGA

• ten (10) meter walk test

• ABC scale(activities specific balance confidence scales

• 6 min walk test

• 5 x STS

(Best F-ing Time After 65 (retirement!))

Functional Reach Test/Multi-directional reach test

assess the max distance patient can reach while maintaining fixed BOS, looking at COG control during reach, and make sure to look at the utilization of abnormal ankle or hip strategies during reach

cut-off for functional reach test

depends on age, but generally a score of less than 14 inches indicates an increased fall risk.

cut off scores for romberg

less than 20 seconds indicates increased fall risk.

single leg stance test

A test measuring the ability to maintain balance on one leg for a period of time, typically assessing stability and risk of falls. Performance may vary with age and health status. scores less than 20 seconds are associated with increased fall risk in older adults

tinetti

An assessment tool for evaluating sitting balance and gait assessment in older adults, with a total score ranging from 0 to 28. Scores below 19/28 indicate a high risk of falls.

Cut off score for tinetti?

Less than 19/28

mini-BEST

An advanced balance assessment tool designed to evaluate dynamic balance and postural stability, consisting of various tasks that challenge different aspects of balance. It helps identify individuals at risk for falls. Assesses anticipatory balance, postural control, and dynamic gait tasks, with a maximum score of 28.

norms for the mini-BEST?

• 60-69: 25/28

• 70-79: 23/28

• 80-89: 22/28

• 90+: 17/28

FGA (functional gait assessment)

tests dynamic balance during walking, highly recommended for those with chronic vestibular dysfunction. adds narrowing base of support, walking with eyes closed and ambulating backwards. more advanced than the DGI and able to use AD but max score for each item would then be 2/3

cutoff for FGA?

less than 22/30 is predictive of falls in community dwelling older adults, less than 20 is predictive of unexplained falls in community dwelling older adults in next 6 months

DGI (dynamic gait index)

tests ability to modify balance during walking in presence of external demands, highly recommended for those with acute and chronic vestibular dysfunction. can use AD but max score for each item would be 2/3.

cutoff for DGI?

less than 19/24 indicates risk of falls

MMSE

commonly used screening test for cognitive impairment- heavily weighted in domains of orientation and verbal cognition. cutoff score of less than 24/30

MOCA

more comprehensive cognitive screening instruments with more items related to executive function. more sensitive to detecting mild cognitive impairment and early dementia. cut off score of less than 26/30

which balance/gait/functional activity exams allow for use of an AD?

• TUG

• Tinetti

• FGA and DGI but with max score of 2/3 per item

• mini-BEST you can also use but get decreased scores per certain items