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Measurement in CVA

Measurement in CVA. Addendum slides. Wonderful resource. McGill University in Canada has a website called the Stroke Engine. It has best evidence for a variety of interventions, as well as a wide host of interventions. http://www.strokengine.ca/

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Measurement in CVA

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  1. Measurement in CVA Addendum slides

  2. Wonderful resource • McGill University in Canada has a website called the Stroke Engine. • It has best evidence for a variety of interventions, as well as a wide host of interventions. • http://www.strokengine.ca/ • http://www.medicine.mcgill.ca/strokengine-assess/

  3. Barthel Index • A study just published in Stroke (vol 42, 2011) by Kwakkel, Verbeek, et al. reported that Day 5 post stroke is the earliest time this test can be used to make an optimal prediction of functional outcomes of ADLs at 6 months.

  4. More on the Berg… • It has been tested with persons with stroke. • It has also been evaluated to determine the MDC (minimal detectable change) needed to demonstrate genuine change in performance. • A change of 6 points is necessary to be 90% confident of true change.

  5. New Balance Assessment • Horak and colleagues developed a new test of balance called the BESTest (Balance Evaluation Systems Test) which has been evaluated for psychometric quality. • A new, shortened version of the test has been developed (from 36 to 14 items) and takes only 10-15 minutes to complete. (Please see Journal of Rehabilitation Medicine 2010: 42: 323-331.)

  6. Sitting balance measure • There is also a new sitting balance assessment called the FIST (Function in Sitting Test) which was just published in JNPT, volume 34, Sept 2010, pp. 150-160. • There are 14 items included in the test, such as • Sitting with eyes closed • Pick object up off floor • Lateral scooting without using arms • Maximum score is 56

  7. The Four Square Step Test • The Four Square Step Test is an easy to use, dynamic test of standing balance that has been tested with persons after stroke. • It has been found to be reliable, as well as sensitive to change. • It is recommended ONLY for persons with stroke who can walk at least 50 meters with minimal assistance or less. • Preliminary data suggest increased risk of falls for persons requiring more than 15 secondsto complete the test.

  8. Additional gait speed info • Additional research on the 6MWT suggested a change of 54.1m for persons undergoing inpatient rehabilitation.* • MDC change for gait speed in individuals undergoing inpatient rehabilitation was determined to be 0.30 m/sec (59 ft/min).** • Other research has shown that a change of .18 m/s was significant at 20 days post stroke and .39 m/s was significant at 60 days post onset.

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