SCALES

ASIA SCALE (Spinal Cord Injury).

The ASIA (American Spinal Injury Association) classification establishes the

basic definitions of the terms used in the evaluation of spinal cord injury and
establishes a classification according to five degrees determined by the
absence or preservation of motor and sensory function, indicating the severity
of the injury. said injury and its possible prognosis.

Once the key point has been found at both the motor and sensory levels, we
proceed to classify the level of the injury:

A complete : Motor and sensory function not preserved in the sacral segments
S4 – S5

B incomplete : Sensory but not motor function preserved below the

neurological level and includes the sacral segments S4 – S5

Incomplete C : Preserved motor function below the neurological level, and

more than half of the key muscles below the neurological level have a muscle
grade less than 3

D incomplete : Preserved motor function below the neurological level, and at

least half of the key muscles below the neurological level have a muscle grade
>= a 3

Normal E : Sensory and motor function are normal.

BARTHEL SCALE
AUTONOMY FOR THE ACTIVITIES OF DAILY LIFE.
The range of possible values of the Barthel index is between 0 and 100, with
intervals of 5 points. The lower the score, the more dependency; and the higher
the score, the more independence. Additionally, the Barthel Index can be used
by assigning scores with 1-point intervals between categories – possible scores
for activities are 0, 1, 2, or 3 points – resulting in an overall range between 0
and 20. The cut-off points suggested by some authors to facilitate interpretation
are:

- 0-20 total dependence.

- 21-60 severe dependence.
- 61-90 moderate dependence.
- 91-99 low dependency.
- 100 Independence.
PAIN SCALES (Scales to assess pain; Categorical Scale, VAS Scale,
Luesher Gray Scale, Luminous Analogue Scale, Numeric Scale, Verbal-
Keele Scale).

The scales help detect pain. In the field of intensive care there are different
types of patients and therefore the evaluation scales must be appropriate for
each of them.

1.- Categorical Scale.

It is used if the patient is not able to quantify the symptoms with the other
scales; expresses the intensity of symptoms in categories, which is easier. An
association is established between categories and a numerical equivalent.

2.- VAS Scale (Visual Analog Scale).

It is a very simple test in which the patient marks the intensity of the proposed
symptom on a scale of 1-10. The studies carried out show that the value of the
scale reliably reflects the intensity of the pain and its evolution. Therefore, it is
used to evaluate the intensity of pain over time in a person, but it is not useful to
compare the intensity of pain between different people. It can also be applied to
other quality of life measures.

3.- Luesher Gray Scale.

The gray scale uses color intensity as a variant to quantify in a palette of
shades of a horizontal or vertical bar that ranges between the absence of the
pain of white and the maximum pain of black.

4.- Analog Luminous Scale.

The Nayman light scale uses colors in a gradation of light intensity ranging from
no pain (white) to maximum pain (violet).
White – yellow – orange – red – violet
Other scales use several parameters simultaneously in order to make the
requested task more understandable (facial, numerical, descriptive, luminous).
All these options represent an alternative assessment, the important thing is to
always use the same scale with the same patient.

5.- Numerical Scale.

Numbered scale from 1-10, where 0 is the absence and 10 is the greatest
intensity, the patient selects the number that best evaluates the intensity of the
symptom. It is the simplest and the most used.

6.- Verbal-Keele Scale.

This scale is based on five degrees which are as follows:
KATZ SCALE
The Katz index presents eight possible levels:

A. Independent in all its functions.

B. Independent in all functions except one of them.
C. Independent in all functions except the bathroom and any other
functions.
D. Independent in all functions except bathing, dressing and any other
functions.
E. Independent in all functions except bathing, dressing, using the toilet and
any other.
F. Independence in all functions except bathing, dressing, using the toilet,
mobility and any other of the remaining two.
G. Dependent in all functions.
H. Dependent in at least two functions, but not classifiable as C , D , E or F.

In a conventional way the following classification can be assumed:

Grades AB or 0 - 1 points = absence of disability or mild disability.

Grades CD or 2 - 3 points = moderate disability.

EG or Grades 4 - 6 points = severe disability.

LOWTON BRODY SCALE (Instrumental Activities of Daily Living) (IADL).
Each area is scored according to the description that best corresponds to the
subject. Therefore, each area scores a maximum of 1 point and a minimum of
0 points . Maximum dependence would be marked by obtaining 0 points ,
while a sum of 8 points would express total independence.
LOVETT SCALE (For the assessment of Muscle Strength).
Observe the musculature itself, the appearance and shape of the muscle.

Palpatory assessment:

-Exerting a series of pressures-depressions with the fingers. It can be done with

the tip of one or more fingers or with the entire surface of the hand.

-Press with your fingertips on the muscle and slide your fingers transversely
with respect to the longitudinal muscle axis.

We can measure musculature by measuring muscle strength, since this way we

can see the muscle's ability to contract.

We can assess our patient's degree of movement using the Lovett scale.

ASHWORTH SCALE
Tinetti scale for assessing gait and balance.
Indicated: Early detection of the risk of falls in the elderly within one year.

Administration: Carry out an approach by asking the patient: Are you afraid of
falling? It has been seen that the positive Predictive Value of the affirmative
response is around 63% and increases to 87% in frail elderly people.
Completion time 8-10 min. The evaluator walking behind the elderly person is
asked to answer the questions of the walking subscale. To answer the balance
subscale, the interviewer remains standing next to the elderly person (in front
and to the right). The score is totaled when the patient is sitting.

Interpretation: The higher the score, the better the performance. The maximum
score for the gait subscale is 12, for the balance subscale 16. The sum of both
scores for fall risk. The higher the score >>>the lower the risk <19 High risk of
falls

19-24 Risk of falls.

Psychometric properties: It is not validated in Spanish and in our context.

TINETTI SCALE. PART I: BALANCE

TINETTI SCALE. PART II: MARCH
Instructions: The subject standing with the examiner walks first with his usual
gait, returning with a “quick but sure gait” (using his usual walking aids, such as
a cane or walker).