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Functional Independence Measure (FIM) was developed to address what? Developed where, when?
- the issues of sensitivity and comprehensiveness that were criticized as being problematic with the Barthel Index (another measure of functional independence).
- dev in SUNY Buffalo -- 1996???
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breakdown of questions/sections on the FIM, and how many possible pts/item
7-level scaling system -- a score of 0/not tested is allowed on day 1, but afterwards the lowest score is a 1
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the meanings of the 7 scores in the FIM
- INDEP
- 7: complete independence
- 6: modifed indep (needs an AD, extra time, there are safety considerations)
- DEPENDANT
- MOD DEP
- 5: supervision or setup required
- 4: minimal contact assist required - but subject does <75% of work
- 3: mod assist - pt does 50-75%
- COMPLETE DEP
- 2: max assist - pt des 25-50%
- 1: total assist - pt does <25%
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on the Nagi model, what does the FIM look at?
- functional limitations
- some impairment (cogn func)
- some disability (social interaction)
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criticism of the FIM? lead to?
- not comprehensive enough
- so, in response to this and to more pts surviving head trauma, the FAM (functional assessment measure) was made to supplement the FIM (functional indep measure)
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the FAM was made whee? derived for whom?
- Santa Clara Valley Medical Center
- for pts brain injury
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what did the FAM add to the FIM
12 cognitive areas, bringing the total to 30 areas to score on the 7-level ordinal scale
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on the Nagi model, FAM looks at...?
- functional limitations
- impairments (cognitive)
- disability (employability etc)
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Motor Assessment Scale - dev by whom?
Carr and Shephard
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a few things to know about the MAS (slide says we'll get into greater detail in a later unit)
- it's an impairment/functional limitation ybrid
- could be used w Barthel to get better pic f pt's general function
- cold be used w Frenchay Arm Test to help clarify functional limitations in UE
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NIH stroke Scale is designed to be what? looks at what?
- a compreensive picture of pts w stroke
- looks at IMPAIRMENTS (while Barthel look at function)
- levelof consciousness
- gaze
- visual
- facial paralysis
- motor arm
- motor leg
- limb ataxia
- sensory
- best lang
- dysarthria
- extinction and inattention
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Modified Rankin Scale - rated by whom? out of what score? made when?
- rated by outsider - not the pt
- it's a 0-6 scale 0= fine, 6 = dead
- 1957
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Rankin scale, meaning of each rank
- 0=go for icecream
- 1=some symptoms
- 2=slight disability but basically indep
- 3=req some help but can walk w/o assist
- 4=mod to severe disability, can't walk or attend to bodily needs w/o assist
- 5=severe disability, bedridden, incont
- 6=dead
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Tinnetti Balance Measure - real basic descrip
similar to Berg Balance Scale but w more tests so more time consuming
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functional reach test
done sitting or standing - just see how far pt can reach
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Frenchay Arm Test -basic descrip and scoring
- 5 function-based tasks to be done w affected arm
- 0=unable 1=completed
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3 benefits of Frenchay Arm Test
valid, reliable, quick
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utility of FIM, Fugl-Meyer, Barthel Index, and MAS in clinical practice
- FIM - widely accepted in rehab and home care settings
- Fugl-Meyer - used by folks who follow Brunnstrom, also used for research
- Barthel Index - quick measure of gen function, so it's used often
- MAS - used often outside the US
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which tests are used as god standards to judge concurrent validity of other motor scales?
Fugl-Meyer and MAS
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which test is ofe used aone or in combo w other masures fr showing general functional outcome of an intervention?
Barthel
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QOL measure test
- a stroke-specific qol scale, self-reported or w help from fam
- a bit confusing
- risk of perseveration - pt sticking w one answer again and again regardless of the qs
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homonymous hemianopsia
losing sight in both eyes on the same side - R half or L half loss for both
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agnosia
can't name an object
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apraxia
- can't coordinate movements in sequence
- ex - dressing apraxia
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