OUTCOME MEASURES Flashcards
OUTCOME MEASURE: def, why important, ≠ types
- Vital part of understanding quality if provide
- Thanks to OM, can improve service
- Tool used to assess patient’s current status
- Tool identifying impact that PT has on patient
Guide clinical decision making process
- Self-report measures
- Performance- based measures
- Clinician- reported measures
EVIDENCE BASED PRACTICE: components
Clinical expertise
Research evidence
Info from practice
Client’s values, circumstances..
OUTCOME MESURE: task 1 def & components
How can objectively measure properties or fct of muscles?
Knee fct OM, dynamic balance OM, muscle strength OM, flexibility OM, pain OM
Knee fct OM: ≠ tests
Knee injury & osteoarthritis outcome score
Developed in 1990s
- Self-administered questionnaire
- Assess knee & associated pbs
- 42 items
- Consists of 5 subscales; Pain, other symptoms, function in ADL, function in sport & recreation (Sport/Rec) & knee related, quality of life
- Can assess changes from week to week or over years following primary injury or OA
Western Ontario & mc master univ OA index
- Developed in 1982 at Western Ontario & McMaster Universities
- Self-administered questionnaire
- Evaluation of Hip & Knee OA - 24 items divided into 3 subscales (pain, stiffness & physical function)
- Available in over 90 languages
International knee documentation committee
- Development in 1987
- Measures symptoms, function & sports activity in variety of knee conditions- overall function score
- Evaluates: pain, stiffness, swelling & giving- way of knee
Pain OM: tests
Numerical rating scale
Wong Baker FACES
Mc Gill Pain questionnaire
- Designed by Melzack (1975)
- Self-reporting measure
- Can be used to evaluate person experiencing pain
- Diagram of body shown to patient- mark where pain located on their body - 20 sub-classes of descriptive words
- Pain rating index as words further down list score more points
- Higher pain score -> greater pain
Muscle strength OM test
Dynamometer
Groin bar
Nord bord
Flexibility OM test
ROM measurements: inclinometer & goniometer
Flexibility special tests: sit & reach test / Thomas’s test
Dynamic balance OM test
Star excursion balance test
1. Athlete stood on 1 leg
2. Athlete reached with opposite limb in each direction
3. Each direction at 45° to each other with cm marked to determine reach distance
4. 3 successful reaches with each foot in all directions
5. Athlete cannot touch their foot down on floor before returning back to starting position
Y balance test
1. Stand on centre footplate
2. Reach with free limb anterior, posteromedial & posterolateral directions in relation to stance foot by pushing indicator box as far as possible
3. Perform all 3 trials to each direction
Single leg hop test
1. Described by Barber & Noyes
2. One of most widely utilized functional performance tests after ACL reconstruction (ACLR)
3. LSI of ≥90% -> Return To Sport
4. Can be single hop leg or triple hop test
OUTCOME MEASURES: task 2 def & components
How can we predict or prevent falls?
Fatigue OM, OM for prediction of falls, quality of life & symptoms OM
Fatigue OM test
Multidimensional assessment of fatigue scale
- MAF comprises of 16 questions concerning quantity, degree, distress, impact & timing of fatigue
- Questions 1–15 form final score (Global Fatigue Index, 0–50) whereas question 16 concerns change over past week
- Questions 1–14 are 10-point items, whereas 15 and16 are 4-point items
Fatigue severity scale
- Measures the severity of fatigue and its effect on a person’s activities - variety of disorders
- 9-item scale
- Higher score, more severe fatigue is & more affects person’s activities
- Fatigue Severity Scale key
* Total score of less than 36 suggests that you may not be suffering from fatigue
* Total score of 36 or more suggests that you may need further evaluation by a physician
OM for prediction of falls
Berg balance scale score
- Measure balance of older adult in clinical setting
- Components: 14 items of everyday tasks - Rated on 0-4 scale
- 0-20 high fall risk
- 21-40 medium fall risk
- 41-56 low fall risk
Timed up to go test
- Components: One item-stand, walk 3m, turn come back & sit down
- Stopwatch, Chair (46cm)w/ arms (65 cm)
- Time to Complete Test: 1-2 minutes
- >30 sec need physical assistance with transfers & generally cannot manage steps-prone to fall
- < 20 sec independent with basic transfers
- <10 sec freely independent
5 times sit & stand test
- Assesses functional lower extremity strength, transitional movements, balance & fall risk
- Stand up straight as quickly as can 5 times, without stopping in between
- Further assessment of fall risk: ≥ 12 sec
Quality of life & symptoms OM test
Pelvic floor distress index
- Health-related quality of life questionnaire for women with pelvic floor conditions
- Comprised of 3 scales
- 20 questions
- “yes” or “no” response
- 4-point scale that ranges from “not at all” (0) to “quite a bit”
International consultation on incontinence questionnaire
- Questionnaire for evaluating severity of urinary loss & quality of life for those with urinary incontinence
- 4 questions: frequency of urinary incontinence, amount of leakage, overall impact of urinary incontinence & self- diagnostic item
Prolapse quality of life questionnaire
- Developed in 2005
- Contains 38 simple questions
- General health, prolapse impact, role, physical & social limitations, personal relationships, emotional problems, sleep/energy disturbance as well as severity symptoms’ measurement
Pelvic girdle questionnaire (pregnancy related)
- Assesses activity limitations & symptoms in patients with pelvic girdle pain
- Pelvic girdle pain during pregnancy & postpartum
- 20 activity items & 5 symptom items scored on 4- point response scale
- Each question scored from ‘Not at all’ (0) to ‘To a large extent’
- Questions on activity sub-scale range from difficulty with dressing, climbing stairs, doing housework, rolling in bed to pushing shopping cart
PSYCHOMETRIC PROPERTIES OF OM
Reliability,validity, ceiling effects & normative values
How choose OM
- Ask why
- Ask why you want to evaluate
- Consider what type of info to collect
- Understand what decisions might be made with collected information - WHEN
- Determine when to collect info - Plan in advance - SEARCH & FIND
- Look for & select specific measure for your case
- Implement & incorporate one into clinical practice - Know what to do with results collected - EVALUATE
- Evaluate use in your practice, does OM provide info you need?
What might be attitude toward use of standardized OMS in practice?
- Limited availability of OMs
- Lack of equipment
- Accessibility of forms & space
- Lack of time
- Lack of knowledge about OMs (insufficient)
