Exam 1 Study Guide Flashcards by Haley Highsmith

Dermatomes C2-S3

C2: posterior half of skull
C3: medial end of clavicle
C4: medial acromion below clavicle
C5: lateral elbow
C6: 1st digit/thumb
C7: 3rd digit/middle finger
C8: 5th digit/pinky
T1: medial elbow
T2: anterior axilla
T4: nipple line
T6 or T7: xiphoid process
T10: umbilicus
T12: anterior iliac crest/pubic symphysis
L1: inguinal region/upper medial thigh
L2: medial thigh mid-distance
L3: medial knee
L4: medial malleolus
L5: base of great toe
S1: lateral heel/lateral malleolus
S2: posterior knee
S3: ischial tuberosity

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Myotomes C1-S2

C1‐C2 Neck Flexion/Extension
C3 and CN XI Neck Side Flexion (Side Bending)
C4 and CN XI Shoulder Elevation
C5 Shoulder Abduction / Shoulder Lateral Rotation / Elbow Flexion
C6 Elbow Flexion, Wrist Extension
C7 Elbow Extension, Wrist Flexion
C8 Thumb Extension, Ulnar Deviation, Finger Flexion
T1 Hand Intrinsics, Abduction/Adduction
L2 Hip Flexion
L3 Knee Extension
L4 Ankle Dorsiflexion
L5 Toe Extension
S1 Ankle Plantar Flexion, eversion and hip extension
S2 Knee Flexion

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Modified Ashworth Scale scoring

0 = no increase in tone
1 = slight increase in tone with catch at end of ROM
1+ = slight increase in tone with minimal resistance through less than half the ROM
2 = marked increased in resistance through most of the ROM
3 = considerable increase in resistance/PROM is difficult
4 = rigid

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Modified Ashworth Scale testing position and what it is testing for

testing position is to have the patient in supine
it is testing for hypertonia/spasticity

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Describe the head impulse test

Must clear the cervical spine before performing
Tests for a lesion in the VOR system (vestibuloocular reflex)
Must rotate head at >200 degrees per second with a small amplitude of 10-20 degrees
A positive test indicates a lesion on the same side that the head was turned (eg. positive head turned to left indicates a left lesion)

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Symptoms associated with a cerebellum lesion

Ataxia: irregular stepping, wide BOS, arms at high guard position, poor trunk control
Diadochokinesia: impaired rapid alternating movements
Dysmetria: over/under shooting movements
Dyssynergia: inability to perform smooth movements
Dysarthria: scanning speech, holds onto syllables for too long
Intention tremors
Nystagmus: mostly vertical nystagmus

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Purpose of outcome measures

Discriminate: categorize people into groups
Evaluate: evaluate change over time and effectiveness of treatment
Predict: help with prognosis and D/C planning, can identify risk

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Commonly accepted gait speed that has been said to reduce fall risk

0.8 meters per second

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Ceiling and floor effects

Ceiling effect: the amount of people who score 100% on an outcome measure, want it to be ≤15%
Floor effect: the amount of people who score 0% on an outcome measure

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What is the berg balance scale scored out of

scored out of 56

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What is the cutoff score for fall risk on the berg balance scale

≤45 out of 56

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What are the items in the berg balance scale

14 items total
1) Sit <> stand
2) Stand unsupported
3) Sit unsupported
4) Stand <> sit
5) Transfers
6) Stand eyes closed
7) Stand feet together
8) Reach forward
9) Pick up an object from the ground
10) Look over shoulder/behind you
11) Turn 360º
12) Place alternate foot on stool/step
13) Stand with one foot infront of the other/tandem stance
14) Stand on one foot

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What type of outcome measure is the berg balance scale

Performance based outcome

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What type of outcome measure is the functional gait analysis (FGA)

Performance based outcome

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What are the items in the functional gait analysis (FGA)

10 items total
1) Gait level surface
2) Change in gait speed
3) Gait with horizontal head turns
4) Gait with vertical head turns
5) Gait with pivot turn
6) Step over an obstacle
7) Gait with NBOS
8) Gait with eyes closed
9) Ambulating backwards
10) Steps

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What is the FGA cutoff score for fall risk in geriatric populations

<22 out of 30

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What is the FGA cutoff score for fall risk in Parkinson’s

<15 out of 30

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What type of outcome measure is the ABC Scale (activities-specific balance confidence scale)

Self-report based outcome

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What is the ABC Scale cutoff score for fall risk in the general population

<67% out of 100%

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What is the ABC Scale cutoff score for fall risk for vestibular patients

<67% out of 100%

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What is the ABC Scale cutoff score for fall risk for Parkinson’s

<69% out of 100%

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What is the ABC Scale cutoff score for fall risk for stroke patients

<81% out of 100%

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What type of outcome measure is the TUG (timed up and go)

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Performance based outcome

How do you perform a TUG (timed up and go)

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Patient starts seated in a chair with armrests
Have patient walk to a 3 meter mark from the chair, turn around to walk back towards the chair, and end seated in original chair
Time the patients from the moment you say go to the time their butt hits the chair again

What is the TUG (timed up and go) cutoff score

- between 11-13 seconds

What does the Orpington Prognostic scale measure

- Measures stroke severity

Scoring categories for the Orpington Prognostic scale

- Minor stroke = <3.2 - Moderate stroke 3.2-5.2 - Major stroke >5.2

What type of outcome measure is the 10MWT

- Performance based outcome

How do you perform the 10MWT

- Have 10 meters marked out on the floor with additional markers at 2 meters and 8 meters - Instruct patients to walk at a comfortable speed to the 10 meter mark - Start timing once the patient hits the 2 meter mark and stop the timer when the reach the 8 meter mark

What is the 10MWT cutoff score for a patient being dependent in their ADLs/IADLs and more likely to be hospitalized

- ≤ 0.6 m/s

What is the 10MWT cutoff score for a patient to be independent with ADLs/IADLs, less likely to be hospitalized, and less likely to have an adverse event

- ≥1.0 m/s

What is the 10MWT cutoff score for a patient to be D/C to a SNF

- ≤0.1 m/s

What is the 10MWT cutoff score for a patient to be D/C to home more likely

- ≥ 0.1 m/s

What is the 10MWT cutoff scores for a patient's ambulation status

- Household walker = <0.4 m/s - Limited community ambulator = 0.4-0.8 m/s - Community ambulator = 0.8-1.2 m/s - Cross street/Normal walking speed = >1.2 m/s

What are the 6 CTSIB conditions for testing balance

1) Stable ground 2) Stable grind with eyes closed 3) Stable ground with altered vision/visual environment 4) Unstable ground 5) Unstable ground with eyes closed 6) Unstable ground with altered vision/visual environment

What are the conditions for the modified/mCTSIB test for balance

1) Stable ground 2) Stable ground with eyes closed 3) Unstable ground 4) Unstable ground with eyes closed

What type of outcome measure is the CTSIB and mCTSIB

- Performance based outcomes

Hedmen’s temporal stages model for movement analysis of tasks

- Initial conditions: observe posture, environmental conditions to check if pt is in a position to perform the task - Preparation phase: did the pt understand the instructions to get in the ‘ready position/posture’ - Initiation phase: the initial movement of the task - Execution phase: majority of the task - Termination phase: observe stability at end of the task

What is the dynamic systems theory (motor control theory)

- Postural control movements are also guided by the task at hand, our individual capabilities, & the environmental constraints

What is the reflex theory (motor control theory)

- Movement is controlled by stimulus-response

What is the hierarchical theory (motor control theory)

- One thing leads to the another in a specific order

What type of outcome measure is the 6MWT

- Performance based outcome

What type of outcome measure is the 5TSTS

- Performance based outcome

How to perform a 6MWT

- Have the patient start standing and begin to walk at a comfortable speed for 6 minutes while you walk behind to measure distance and to not set their pace

What is a general normative value for the 6MWT

- 400-700 meters within 6 minutes

How to perform a 5TSTS

- Have the patient start seated in a chair and ask them to complete five sit to stands as quickly as they can with their arms folded across their chest - Time them and make sure to count the standings

What is the 5TSTS cutoff for predicting recurrent falls and disability/morbidity

- Disability/morbidity = unable to complete in <13.6 seconds - Recurrent falls = ≥15 seconds

What type of outcome measure is the FRT (functional reach test)

- Performance based outcome

How to perform the FRT (functional reach test)

- Have the patient stand with their arm straight out in front of them at shoulder height - Instruct patient to reach forward as far as they can without losing balance/needing to take a step - Measure the distance their hand moved from its original spot - Do 3 trials and take the average of the last 2

What type of outcome measure is the PASS (postural assessment scale for stroke patients)

- Performance based outcome

What items are included in the PASS (postural assessment scale for stroke patients)

- 12 items total 1) Sit unsupported 2) Stand supported 3) Stand unsupported 4) Stand on nonparetic leg 5) Stand on paretic leg 6) Supine to paretic side 7) Supine to nonpareil side 8) Supine to sit at edge of bed 9) Sit at edge of bed to supine 10) Sit to stand 11) Stand to sit 12) Pick a pencil up from the floor

What type of outcome measure is FMA (Fugl Meyer Assessment)

- Performance based outcome - Good for stroke patients

What are the items are included in the FMA UE (Fugl Meyer Assessment UE)

- Reflexes: biceps or finger flexors and triceps - Movement within synergies: hand from contralateral knee to ipsilateral ear and vic versa - Movement mixing synergies: hand to lumbar spine, shoulder abduction to 90º, and pronation/supination - Movement with little/no synergy: shoulder ABD to 90º, shoulder flexion to 180º, and pronation/supination - Coordination/speed: tremor, dysmetria, and/or time - Sensation: light touch to upper arm, forearm, and palm of hand and position for shoulder/elbow/wrist and thumb - Passive joint motion: shoulder, elbow, forearm, wrist, and fingers

What are the items are included in the FMA LE (Fugl Meyer Assessment LE)

- Reflexes: knees flexors and patellar tendon or Achilles - Movement within synergies: max hip/knee/ankle flexion and max hip/knee/ankle extension - Movement mixing synergies: AROM/PROM knee flexion and dorsiflexion - Movement with little/no synergy: knee flexion to 90º and dorsiflexion - Coordination/speed: tremor, dysmetria, and/or time - Sensation: light touch to sole of foot and leg, position of hip/knee/ankle and great toe - Passive joint motion: hip, knee, ankle, foot

What outcome measures are good for stroke patients

- STREAM - PASS - FMA - OPS - SIS (stroke impact scale)

What does the OPS (Orpington Prognostic Scale) tests/look for

- Motor defect in arm - Proprioception - Balance - Cognition (Hodkinson's Mental Test) - Greatest power of extensors in affected limb

What type of outcome measure is OPS (Orpington Prognostic Scale)

- Performance based outcome

Exam 1 Study Guide Flashcards

(57 cards)