Volume 7:2
Test Items in the Complete and Short Forms of the BOT-2 that Contribute Substantially to Motor Performance Assessments in Typically Developing Children 6-10 Years of Age
Kadi Carmosino, SPT; Ashley Grzeszczak, SPT; Kaylie McMurray, SPT; Ali Olivo, SPT; Bo Slutz, SPT; Brittany Zoll, SPT; Betsy Donahoe-Fillmore PT, PhD, PCS; C. Jayne Brahler, PhD
Doctor of Physical Therapy Program, University of Dayton – Dayton, Ohio
Abstract
Objectives: The objectives of this study were to determine the magnitude of association between individual subtest items of the Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2), and the respective total subtest scores and to review items on the BOT-2 Short Form.
Background: The Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2), is a test used to measure gross motor proficiency in both typically developing children and children with developmental disabilities between the ages of four and twenty-one. The BOT-2 Short Form consists of fourteen test items proportionally selected from the subtests of the Complete Form. It can be used as a screening tool and takes less time to administer.
Methods and Measures: A convenience sample of forty-four children (twenty-one male, twenty-three Female; six to ten years), who were enrolled at a Midwestern elementary school, participated. Data was collected in one session. The BOT-2 subtests of Manual Dexterity, Bilateral Coordination, Running Speed and Agility, and Upper Limb Coordination were administered to subjects. Subjects progressed through the subtests in random order and each subtest was graded and administered by a consistent person. Means and standard deviations were calculated for the scores on the individual subtest items. Pearson correlation tests were run to determine the magnitude of the association between the individual subtest items and the respective subtest total score; the magnitude of association was assessed to see if the items that comprise the Short Form were strongly associated with their subtest total score.
Results: All items in the Manual Dexterity, Running Speed and Agility, and Upper Limb Coordination subtest were significantly correlated (p < 0.05) with their overall subtest score. Two items in the Bilateral Coordination subtest were not significantly correlated with the overall subtest score, one that was included on the Short Form.
Conclusions: Most items on the BOT-2 subtests administered were significantly correlated with their overall respective subtest scores. However, revisions to the short form may be needed in order to include more items that are all significantly correlated with their respective subtest scores.
Use of the Modified Functional Reach Test in a Patient with Friedreich’s Ataxia
Danielle Chamberlain, SPT; Michelle Donahue, PT, DPT, PCS
Nazareth College of Rochester – Rochester, New York
Abstract
Background: Friedreich’s Ataxia (FRDA) is a progressive, multi-system degenerative disorder of the spinal cord, peripheral nerves, and cerebellum. A progressive loss of lower extremity strength and coordination leads to a loss of ambulation and an increased reliance on postural stability for wheelchair positioning and transfers. Quantifying seated balance has added importance for non-ambulatory patients. The Friedreich’s Ataxia Rating Scale (FARS) is the gold-standard to measure functional disability, activities of daily living, and disease progression; however, patients in the advanced stage of the disease are unable to complete many test items. The Modified Functional Reach Test (mFRT) may provide a clinically relevant alternative. The purpose of this case report is to demonstrate the use of the mFRT to document changes in seated balance for a non-ambulatory patient with FRDA.
Case Description: The subject was a non-ambulatory, twenty-four year old male with FRDA. His primary physical therapy goal was to improve sitting balance. The FARS was administered initially and after six weeks of physical therapy service and the Modified Functional Reach Test (mFRT) was administered weekly.
Outcomes: The patient required increased assistance to safely complete transfers and bed mobility. The FARS scores remained unchanged. Scores on the mFRT decreased from 30.5 cm to 5.0 cm (forward direction) and from 7.5 cm to 4.0 cm (right direction), demonstrating a quantitative change in seated balance for this non-ambulatory patient.
Conclusion: Physical therapists should consider using the mFRT as a quantitative measure of seated balance in this patient population.
The Exclusion of “Bed Exercises” for Patients Following a Total Knee Arthroplasty (TKA) and its Effect on Functional Outcomes
Justin K. Bell, SPT; Ellen Perlow, PT, DPT
College of Health Professionals, Physical Therapy Program, Mercer University – Atlanta, GA
Abstract
Background: The plan of care for patients following total knee arthroplasty (TKA) often entails functional retraining and “bed exercises.” Existing research demonstrates that the inclusion of “bed exercises” to a treatment plan focused on functional retraining does not produce significant improvements in outcomes for patients post hip arthroplasty.5,11 This case report aims to determine whether functional retraining, without the addition of “bed exercises,” is an appropriate intervention strategy for a patient status-post TKA.
Case Description: The subject of this case report was a 5’2″, 76 year old woman, weighing 202 pounds, who underwent an elective TKA secondary to osteoarthritis. At initial evaluation, the patient required moderate to maximal assistance with functional skills, as scored by the Iowa Level of Assistance Scale (ILAS)9. Active range of motion (AROM) of her knee was 10°-85°. Physical therapy interventions focused on functional retraining to increase the patient’s knee ROM and strength and decrease activity limitations to facilitate a safe return to her home.
Outcomes: The patient’s improvements were evident in decreased ILAS scores from 32 to 13 in 4 days and a discharge home, bypassing a stay in sub-acute rehab. Knee ROM improved to 0°-105°. Observational gait analysis improvements included a step-through gait pattern, appropriate heel strike bilaterally, increased stance time on the involved extremity, and an improved weight shift throughout the gait cycle.
Conclusion: This case report supports 1) eliminating “bed exercises;” and 2) emphasizing functional retraining to maximize patient outcomes and the delivery of cost-effective care.
