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final-review 35

Outcome Measurement Tools

QuestionAnswer
Outcome is the term used to qualitatively describe the end result of a particular intervention including changes (good or bad) that occurred to the health of a person, group or community.
Factors that influence outcome include: primary diagnosis, comorbidities, medical stability, prior physical status, current physical status, age and gender, beliefs, and attitudes.
Balance: Berg Balance Scale Functional Reach Test “Get Up and Go” Test Romberg Test Tinetti
Berg Balance Scale A tool designed to assess a patientʼs risk for falling. There are fourteen tasks, each scored on an ordinal scale from 0-4.
Berg Balance Scale tasks include static, transitional, and dynamic activities in sitting and standing positions.
Berg Balance Scale The maximum score is a 56
Berg Balance Scale with a score less than 45 indicating an increased risk for falling.
Berg Balance Scale used as a one-time examination or as an ongoing tool to monitor a patient who may be at risk for falls.
Functional Reach Test A single task screening tool used to assess standing balance and risk of falling. A person is required to stand upright with a static base of support.
Functional Reach Test A yardstick is positioned to measure the forward distance that a patient can reach without moving the feet.
Functional Reach Test Three trials are performed and averaged together. The following are age related standard measurements for functional reach:
Functional Reach Test 20 - 40 years – 14.5 - 17 inches
Functional Reach Test 41 - 69 years – 13.5 - 15 inches
Functional Reach Test 70 - 87 years – 10.5 - 13.5 inches
Functional Reach Test A patient that falls below the age appropriate range for functional reach has an increased risk for falling.
Functional Reach Test The outcome measure demonstrates high test-retest correlation and intrarater reliability.
“Get Up and Go” Test A functional performance screening tool used to assess a personʼs level of mobility and balance.
“Get Up and Go” Test The person initially sits in a supported chair with a firm surface, transfers to a standing position, and walks a few feet. The patient must then turn around without external support, walk back towards the chair, and return to a sitting position.
“Get Up and Go” Test The patient is scored based on amount of postural sway, excessive movements, reaching for support, side stepping, or other signs of loss of balance.
“Get Up and Go” Test The 5-point ordinal rating scale designates a score of one as normal and a score of five as severely abnormal.
“Get Up and Go” Test In an attempt to increase overall reliability the use of time was implemented.
“Get Up and Go” Test Patients who require over 20 seconds to complete the process may be at an increased risk for falling.
Romberg Test An assessment of balance that positions the patient in unsupported standing, feet together, upper extremities folded, and eyes closed.
Romberg Test A patient receives a grade of “normal” if they are able to maintain the position for 30 seconds.
Tinetti Performance Oriented Mobility Assessment A tool used to screen patients and identify if there is an increased risk for falling.
Tinetti The first section assesses balance through sit to stand and stand to sit from an armless chair, immediate standing balance with eyes open and closed, tolerating a slight push in the standing position, and turning 360 degrees. A patient is scored from 0-2 in most categories with a maximum score of
Tinetti The second section assesses gait at normal speed and at a rapid, but safe speed. Items scored in this section include initiation of gait, step length and height, step asymmetry and continuity, path, stance during gait, and trunk motion. A patient is scored either 0 to 1 or 0 to 2 with a maximum score of 12. The tool has a combined maximum total of 28 with the risk of falling increasing as the total score decreases.
Tinetti A total score less than 19 indicates a high risk for a fall.
Cognitive Assessment: Mini Mental State Examination Short Portable Mental Status Questionnaire
Mini Mental State Examination A tool designed to screen patients for cognitive impairment, psychoses or affective disorders.
Mini Mental State Examination Each of the five sections: orientation, registration, attention and calculation, recall and language, and motor skills have multiple questions that receive one point for the correct answer or zero for the incorrect answer.
Mini Mental State Examination There is a maximum score of 30 with a progressive level of cognitive impairment noted when a score of 24 or less is obtained.
Short Portable Mental Status Questionnaire A ten item screening tool used to assess cognitive impairment primarily in the geriatric population.
Short Portable Mental Status Questionnaire Orientation, short and long-term memory, practical skills, and mathematical tasks are tested.
Short Portable Mental Status Questionnaire The maximum score is ten with a score below eight indicating cognitive impairment. The lower the score below eight the more significant the cognitive impairment.
Endurance: Six-Minute Walk Test Borgʼs Rating of Perceived Exertion Scale Dyspnea Levels
Borgʼs Rating of Perceived Exertion Scale A tool designed to measure perceived exertion, dyspnea, and exercise intensity. The original scale measures 6 to 20 points and the revised scale measures 0 to 10 points.
Borgʼs Rating of Perceived Exertion Scale The patient is instructed that a 6 (original) or 0 (new) corresponds to walking at a normal pace without fatigue. A score of 20 (original) or 10 (new) indicates high intensity exercise that cannot be completed due to exhaustion.
Borgʼs Rating of Perceived Exertion Scale After an activity a patientʼs score can indicate cardiopulmonary fatigue versus muscle fatigue. The score correlates with exercise intensity, heart rate, oxygen consumption, and blood lactate levels.
Borgʼs Rating of Perceived Exertion Scale Cardiopulmonary training effects can be seen with exercise intensity beginning at a 14 (original) or 4 to 5 (new) respectively. The scale is commonly used for patients with cardiovascular impairments.
Dyspnea Levels A tool designed by Rancho Los Amigos Medical Center that attempts to rate the intensity and level of dyspnea that a patient experiences with activity.
Dyspnea Levels This ordinal scale consists of ratings from 0 to 4. A patient at level 0 is able to perform an activity and count to 15 without any additional breaths required.
Dyspnea Levels Levels 1, 2, and 3 require progressive extra breaths to count to 15. Level 4 indicates that the patient is unable to count while performing an activity.
Dyspnea Levels The test has not been shown to be valid, however, can be used to measure progress or decline during a course of rehabilitation.
Six-Minute Walk Test A tool used to determine a patientʼs functional exercise capacity. The patient walks as far as he or she can for a timed six minutes with rest periods permitted as necessary.
Six-Minute Walk Test The tool is commonly used upon admission, discharge, and to monitor progress or decline throughout physical therapy. It allows for observation of heart rate and oxygen consumption during activity.
Six-Minute Walk Test This tool is administered to various populations including those with cardiac impairments, pulmonary disease, geriatrics with chronic conditions, and patients recovering from orthopedic surgical procedures.
Motor Recovery Fugl-Meyer Assessment
Fugl-Meyer Assessment An ordinal scale used to measure recovery post CVA. The framework is based on Brunnstromʼs sequence of recovery.
Fugl-Meyer Assessment The five areas of assessment are joint movement and pain, balance, upper extremity motor function, sensation, and lower extremity motor function. Each item tested within an area is assigned a score from 0-3.
Fugl-Meyer Assessment The maximum combined score for upper extremity and lower extremity motor function is 100 and can be interpreted as a percentage of motor recovery. A score of 63 indicates approximately 63% return of motor function.
Pain McGill Pain Questionnaire Numerical Rating Scale Visual Analogue Scale
McGill Pain Questionnaire A pain assessment tool that is divided into four parts with a total of 70 questions.
McGill Pain Questionnaire Part 1 Patient marks on a drawing of the body to indicate area and type of pain (internal or external)
McGill Pain Questionnaire Part 2 Patient chooses one word that best describes the pain from each of the twenty categories
McGill Pain Questionnaire Part 3 Patient describes pattern of pain, factors that increase and relieve pain
McGill Pain Questionnaire Part 4 Patient rates the intensity of pain on a scale of zero to five. This tool can be used to establish a baseline, evaluate particular treatment regimens, and monitor progress. It is valid, reliable, and the most widely used pain assessment scale.
Numerical Rating Scale A tool used to assess pain intensity by rating pain on a scale of 0-10 or 0-100. The 0 represents no discernable pain and the 10 or 100 represent the worst pain ever.
Numerical Rating Scale The information is used as a baseline and should be reassessed at regular intervals in order to monitor progress. This scale is easy to administer, assess, and monitor.
Visual Analogue Scale A tool used to assess pain intensity using a 10-15 cm line with the left anchor indicating “no pain” and the right anchor indicating “the worst pain you can have.”
Visual Analogue Scale . The level of perceived pain is indicated on the line and is reassessed frequently over the course of physical therapy to record changes and progress, and to predict patient outcome
Visual Analogue Scale This scale can be highly sensitive if small increments such as millimeters are used to measure the patientʼs point of pain on the scale.
The visual analogue scale is a valid tool if measurements are taken accurately.
Self-Care and ADL- Barthel Index Functional Independence Measure (FIM) Katz Index of Activities of Daily Living
- Barthel Index A tool designed to measure the amount of assistance needed to perform ten different activities with a total maximum score of 100.
- Barthel Index activities include bowel management, bladder management, grooming, toilet use, feeding, transfers, mobility, dressing, stairs, and bathing.
- Barthel Index A score of 75-95 denotes mild impairment, 50-70 moderate impairment, 20-45 severe impairment, and below 20 indicates a very severe impairment.
- Barthel Index does not account for cognitive or safety issues and is not sensitive to higher level patients regarding their level of disability.
- Barthel Index remains one of the oldest and most widely used tools that is reliable and possesses predictive validity.
FIM A tool that is primarily used in rehabilitation hospitals in order to determine a patientʼs level of disability and burden of care.
FIM part of the Uniform Data System for Medical Rehabilitation (UDS).
FIM A seven-point scale is utilized to examine 18 areas, which include self-care, sphincter control, transfers, locomotion, communication, and social cognitive activities.
FIM items were designed based on the World Health Organizationʼs Model of Disability.
FIM Scoring between a 1 and 5 denotes a level of dependence
FIM between 6 and 7 a level of independence for a specific item.
FIM This tool is both valid and reliable and is used as a predictor of disability for the CVA population. The FIM is utilized on a larger scale to assess change within rehabilitation programs over time.
Katz Index of Activities of Daily Living A nominal scale index used to identify self-care problems and the level of assistance required with the six areas of bathing, dressing, toileting, transfers, continence, and feeding.
Katz Index of Activities of Daily Living The score for each area is combined and the total score correlates with a letter grade scale (A through G).
Katz Index of Activities of Daily Living Each letter represents a level of ability with “A” representing independence in all six areas, the following letters representing increasing dependence and “G” representing dependence in all six areas.
Katz Index of Activities of Daily Living was originally intended only for inpatient and nursing home settings, however, it is now utilized with patients that require outpatient and community-based services.
Katz Index of Activities of Daily Living It is a simple and quick assessment tool used to efficiently gather self-care information and predict outcome and need for ongoing assistance.
Created by: micah10