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Pre-Program Screening and Assessment

Pre-Program Screening and Assessment. Debbie Rose, Ph.D. Co-Director, Center for Successful Aging California State University, Fullerton. Modified Test of Sensory Interaction in Balance (M-CTSIB). Test of sensory impairment Original test developed by Horak & Shumway-Cook in 1986

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Pre-Program Screening and Assessment

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  1. Pre-Program Screening and Assessment Debbie Rose, Ph.D. Co-Director, Center for Successful Aging California State University, Fullerton

  2. Modified Test of Sensory Interaction in Balance (M-CTSIB) • Test of sensory impairment • Original test developed by Horak & Shumway-Cook in 1986 • 6 conditions in original test; 4 conditions in modified version

  3. Modified Test of Sensory Interaction in Balance • Standardized position: • Feet shoulder width apart, arms folded across chest • Test Items include: • Standing with eyes open, firm surface (3/3) • Standing with eyes closed, firm surface • Standing with eyes open, foam surface • Standing with eyes closed, foam surface

  4. Interpretation of Item Scores • Possible underlying Impairments? • Condition 1- Standing with eyes open, firm surface Poor gaze stabilization Poor use of somatosensory cues Lower body weakness

  5. Interpretation of Item Scores • Possible underlying Impairments? • Condition 2- Standing with eyes closed, firm surface Poor use of somatosensory cues Lower body weakness Fear of falling

  6. Interpretation of Item Scores • Possible underlying Impairments? • Condition 3- Standing with eyes open, foam surface Poor use of visual cues Lower body weakness Poor COG control

  7. Interpretation of Item Scores • Possible underlying Impairments? • Condition 4- Standing with eyes closed, foam surface Poor use of vestibular cues Fear of falling in high sway condition Lower body weakness

  8. Multidirectional Reach Test (MDRT) • Developed by Newton in 1997 • Test of motor impairment • Provides information about limits of stability and type of strategy • Test comprised of reaching in 4 directions without moving feet

  9. Multidirectional Reach Test • Yardstick at shoulder height • Standardized test position: • Feet shoulder width apart, arm extended, palm facing in (“handshake”) with hand extended, heels remain in contact with floor • Subtract end number from starting number • Practice trial, 3 test trials • Score is the average

  10. Multidirectional Reach Test • Mean values: • Forward = 8.9 in • Backward = 4.6 in • Left = 6.6 in • Right = 6.8 in • Individual is either above or below average • Movement provides information about postural strategy

  11. Interpretation of Scores Possible impairments associated with below Average Scores: • Reduced limits of stability • Lower body muscle weakness • Reduced ankle ROM • Fear of falling • Poor dynamic COG control

  12. Fifty Foot Walk Test • Used to identify functional limitations in gait • Specifically measures overall gait speed and ability to alter gait speed to meet changing task demands • Performed at a “preferred” and fast speed. • Slow gait speeds associated with increased risk for falls

  13. Test Procedures • Measure a total distance of 70 feet. Place line at start and end on floor. Place mark up wall at 10 foot and 60 foot mark. • Start stopwatch as foot crosses line at 10 foot mark. Stop watch as foot crosses 60 foot mark. • Gait speed is determined by dividing 50 by time elapsed. (Provides ft/sec value) • Stride length can be determined by counting number of steps taken over 50 feet.

  14. Administration of Test • Verbally instruct participant to walk at “their preferred speed” or “as quickly but safely as possible.” • Walk slightly behind and to the side of the participant during each walking trial. DO NOT SET THE PACE for them.

  15. “Walkie-Talkie” Test • Test is designed to measure participant’s ability to divide attention between two tasks - “walking and talking” in this case • A “positive” response indicates an inability to divide attention between talking and walking. • A “negative” response indicates that the participant is able to continue to divide attention successfully in this task.

  16. Test Administration • As you walk towards the fifty foot walk station, ask the participant an open-ended question: • Example: “What did you do over the weekend?’ • Record a positive score if the participant stops to answer the question; a negative score if the participant continues walking while talking

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