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Hi Lauren,

The average is 70-80% on the first attempt of any of the three exams. Scores improve to the mid-80%s with repeated attempts of the same exam. For example, the first time I attempt Exam 2, my score is likely is 70-80%. If I take Exam 2 a second time, my score likely improves to 85-88%. Hope this clarifies things!

Chrissy

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Hi Jacqueline,

Thanks for pointing this out! You are correct – alpha and beta are inversely related. This is a typo; the question should read “increase the p-value”. Realistically, researcher would not want to use this method for increasing power. The question will be updated today to reflect this!

The question isn’t implying that the researcher would manipulate effect size – only that a larger effect size would result in increased power.

Thanks again!

Chrissy

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Hi Sarah,

I apologize for the delay! Caring for a two-week-old baby girl has temporarily slowed my response times! The average score on the first attempt for the PCS Advantage practice exams is around 70-80% with scores improving to 85-88% on subsequent attempts. As Jessica mentioned, the pass rate on the PCS exam for our participants is 96% – so, if you are scoring in this range on our practice exams, you are likely on track to perform well on the PCS exam. Hope this helps!

Chrissy

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Hi Kerry,

Thanks for posting this! Yes, I believe you are interpreting this correctly. This revision makes more sense clinically for predicting motor recovery.

Chrissy

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Hi Elizabeth!

Thank you for this question! As an NCS, orthopedics is not my specialty, so I had to do some digging to confirm. The website below does a nice job of explaining the difference between “exiting” and “traversing” nerve roots at each spinal level. At the L5-S1 level, the L5 nerve root is exiting the spinal column while the S1 nerve root is crossing the disc to exit at the next level below. In the lumbar spine, disc herniations tend to affect the traversing nerve root due to the most common direction of herniations (posterolateral). In the cervical spine, disc herniations usually affect the exiting nerve root (lateral herniations).

https://www.spine-health.com/conditions/spine-anatomy/radiculopathy-radiculitis-and-radicular-pain#:~:text=Traversing%20nerve%20root.&text=It%20is%20called%20the%20%E2%80%9Ctraversing,at%20the%20L5%2DS1%20level.

Hope this helps!

Chrissy

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Hi Lily,

I emailed you directly but will also post here in case anyone refers to this thread for clarification.

There is a motor test for T1 and it is normal. Therefore, T1 is the lowest level presumed to have normal motor function – because sensation is impaired at T2 (again, it’s a conservative assumption because we know motor function is normal in L2-S1).

Chrissy

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Hi Brittany,

Helen Carey, one of our PCS Advantage instructors, explained these concepts quite well on the PCS Advantage discussion forum earlier this year. Check out her explanation here: http://rehabknowledge.com/forums/topic/sensitivity-vs-specificity/. Let us know if you have any other questions!

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Hi Allison and Abby,

Yes, I think you both figured it out! The motor level on the right is T1 because of sensory impairments between T1 and L2. The motor level on the left is C8 because that is the lowest level with at least 3/5 strength. Had T1 been scored as 5/5 strength on the left, the motor level would be determined based on sensory level.

Chrissy

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FIM scores at the extreme low or high range correspond well with discharge disposition (low scores more likely to be discharged to a facility, high scores more likely to be discharged home). The article linked below explains that individuals scoring less than 40 on the FIM have a 70% probability of being discharged to a skilled nursing facility.

https://onlinelibrary.wiley.com/doi/full/10.1002/j.2048-7940.2006.tb00006.x

Hope this helps!

Chrissy

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Hi Sarah and Kathleen,

If the patient has deep anal pressure OR voluntary anal contraction OR a score of at least 1 on any S4-5 sensory test, the injury is incomplete. Because deep anal pressure is intact and more than 50% of key muscles below the level of injury are graded as at least 3/5, the patient’s injury is classified as AIS D.

Here is an example ISNCSCI matching this patient’s characteristics: http://rehabknowledge.com/exam-3-isncsci/

Hope this helps!

Chrissy

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Hi Rebecca,

I just sent you an email with the necessary documents to apply for CEU approval in Florida.

Chrissy

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You will retain access to all the NCS Advantage materials until March 31. Until that time, you can download all the articles and save to a personal device/cloud for access beyond March.

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Hi Gina,
You would want to move the wheels forward. Moving the wheels forward will improve shoulder biomechanics but also make the wheelchair less stable. This article discusses several aspects of wheelchair configuration, including anterior-posterior axis position of rear wheels: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3944313/

Here is an excerpt from the article:
“The anterior–posterior position of the rear wheels influences two important aspects of wheelchair mobility: stability and manual propulsion. While positioning the wheels rearward improves stability, it limits the user’s ability to reach the handrims in this rearward position, thus reducing the push angle. Alternatively, moving the wheels forward improves propulsion biomechanics but reduces stability. The optimal position of the rear wheels is a client-dependent decision, based on the user’s perception of stability and ease of chair propulsion. However, there are some objective guidelines to support this decision. The rear wheels should be positioned in the most forward position that does not compromise system stability23). Gorce and Louis16) showed that, when moving the rear wheels forward, push angle and shoulder ROM are increased, thus reducing both push frequency and handrim forces, minimizing the risk of upper limb injuries32). In addition to the biomechanical benefits, moving the rear wheels forward diminishes the wheelchair length and, as a result, facilitates turning maneuvers by reducing the rotational inertia of the system24).”

Hope this helps!

Chrissy

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I don’t think you need to spend a ton of time learning to read neuroimaging studies. Recognizing the type of image (i.e., CT, MRI), when each type may be indicated (i.e., acute, sub-acute), and identifying major abnormalities (e.g., severe midline shift) is likely sufficient.

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Hi Kristen,

To my knowledge, this information is not available. If you are able to track it down, I would love to know the average passing raw scores.

Chrissy

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