Outcome Measures

Question 1

Types of outcome measures (3)

Answer 1

Self reported measures (subjective)
Performance based measures
Clinician reported measures (observing patient)

Question 2

What are outcome measures used for?

Answer 2

To determine if the patient is progressing or not. If we are providing the correct treatment.

Question 3

What areas can we utilize MSK outcome measures in? (8)

Answer 3

Muscle strength
Pain
Dynamic balance
ROM
Knee function
Prediction of falls
Fatigue
Quality of life

Question 4

Muscle strength outcome measures (3)

Answer 4

Dynamometer: placed on limb moving against resistance.
Groin bar: Isometric muscle strength, asymmetry. Originally for hip and groin.
Nord bord: Eccentric and isometric hamstring strength. Asymmetry.

Question 5

Pain outcome measures (4)

Answer 5

Numerical Rating Scale (NRS): 0-10.
Wong Baker Scale (Faces): smiling to crying. Good for kids.
McGill Questionnaire: chronic pain, multidimensional aspects of pain.
Visual Analogue Scale (VAS): Pointing to the intensity of pain on a scale.

Question 6

Knee Function Outcome Measures (3)

Answer 6

KOOS: knee injury and OA questionnaire.
WOMAC: hip and knee OA questionnaire.
IKDC: overall functional score. Pain, stiffness, swelling, knee giving way.

Question 7

Dynamic Balance Outcome Measures (3)

Answer 7

Star excursion test: reaching with foot, 45° in all directions.
Y-Balance test: Push box anterior, posterolateral and posteromedial. Foot or hand.
Single leg hop: Functional performance test after ACLR.

Question 8

ROM Outcome Measures (3)

Answer 8

Inclinometer, goniometer.
Sit and reach test: 90° ankles.
Thomas test: hip flexors.

Question 9

Quality of Life and Symptoms Outcome Measures (4)

Answer 9

Pelvic floor distress inventory
International consultation on incontinence questionnaire.
Prolapse QoL questionnaire.
Pelvic girdle questionnaire (pregnancy).

Question 10

Prediction of Falls Outcome Measures (3)

Answer 10

Berg Balance Scale: testing ability to do everyday tasks.
Timed up and go: stand up, walk 3m, turn, walk back, sit down. >30 sec, prone to falls.
5x sit to stand.

Question 11

Fatigue Outcome Measures (2)

Answer 11

Multidimensional assessment of fatigue scale.
Fatigue severity scale.

Question 12

Psychometric Properties of Outcome Measures (4)

Answer 12

Floor/Ceiling Effect
Reliability/Validity
Sensitivity/Specificity
Normative Values

Question 13

Reliability

Answer 13

Consistency of a measure. Extent to which OM is consistent and free from error.

Question 14

Validity

Answer 14

Accuracy of a measure. Measure/test is measuring what it intended to measure.

Question 15

Sensitivity

Answer 15

Rule out. Correctly identifying patients with a disease. True positives. Can also have false positives.

Question 16

Specificity

Answer 16

Rule in. Correctly identifying patients without the disease. No false positives. Can have false negatives.

Question 17

How do we identify correct outcome measures?

Answer 17

Clinical utility: cost, equipment, time, complexity to understand and to score.
Psychometric properties.

Question 18

When do we conduct outcome measure assessment?

Answer 18

First session: set a base line. Occasionally throughout treatment. At the end.

Question 19

What do we need to consider when measuring muscle strength? (8)

Answer 19

State of patient (psychological), medical history, age, gender, job, weight, measure 3 times, instruct patient to use maximal force.

Question 20

Disadvantages of Outcome Measures (6)

Answer 20

Time consuming.
Psychosocial factors might affect outcome.
Cognitive conditions: might not understand.
Not high sensitivity/specificity.
Might not have equipment.
We might not know much about the OM (not keeping up with research).

Question 21

Advantages of Outcome Measures (5)

Answer 21

Increase accuracy, consistency, validity, reliability.
See improvement - objective outcome for patient - motivation.
Confirm or deny a diagnosis.
Starting treatment simultaneously.
Psychological support when asking patient questions - how are you?