Outcome measures

Question 1

Uses for outcome measures

Answer 1

• evidence the PT interventions are effective (EBP, contributing to better health and function of patients)
• often tied to reimbursement
• used in research studies

Question 2

How is the outcome measure typically administered and what are they typically?

Answer 2

• self administered/self assessment
• patients perception of function performance, confidence/difficulty in performing activites, pain status in performing activites
• ADL Driven

Question 3

Outcome measures: initial eval data

Answer 3

• initial abilities/disabilities
• data for setting functional goals

Question 4

Outcome measures: re-eval data

Answer 4

• document progress
• continue PT
• modify goals, create new goals

Question 5

Outcome measures: DC criteria

Answer 5

• attainment of goals –ready for DC from PT
• lack of progress – client plateued DC

Question 6

What should outcome measures have?

Answer 6

• validity
• reliability

Question 7

validity with outcome measures

Answer 7

• measures what is intends to
• inclusion of relevant elements regarding function

Question 8

Reliability

Answer 8

• test-retest: consistency when administered on one or more occasions
• intra-rateer: consistency when adminsistered by 1 rater
• Inter-rater: consistency when administered b more than 1 rater

Question 10

Minimial detectable change

Answer 10

• MDC
• minimal amount of change that exceeds measurement error
• patient is considered to have changed when the difference between scores exceeds the MDC

Question 11

Minimal clinically important difference

Answer 11

• MCID
• point change the translates into a meaninful clinical difference

Question 12

Generic outcome measure

Answer 12

• SF-36 V1& V2 volume 1 is longer
• not specific and screen the whole body

Question 13

OPTIMAL: outpaitent Physical Therapy improvement in movement assessment log

Answer 13

• APTA developed for medicare’s request for outcome data
• administered at initial eval and DC
• patient;s difficulty and self confidence performing:
• 21 items/movements form 3 subscales (UE, LE, Trunk)
• 1-5 scale
• scoring = initial eval - DC score greater score change = more improvement
• can use the subscales alone

Question 14

PSFS

Answer 14

• functional outcome measure for orthopedic conditions
• knee dysfunction
• UE musculoskeletal dysfunction
• joint replacement
• low back pain, spinal stenosis
• neck dysfuncion and whiplash
• lower limb amputees
• MS
• pubic symphysis pain in pregnancy

Question 16

The patient specific functional scale initial assessment and follow up assessments

Answer 16

• intial assessment: patients identify and score up to 3 important activites they are having difficulty with or cant do
• follow up assessments: do you still have difficulty with?
• average score: score dividied by # activites to obtain average score
• lower score means greater disability

Question 17

Condition specific outcome measures

Answer 17

• for a specific anatomical region
• specific conition related to a region

Question 18

DASH- Disbailites of arm shoulder and hand

Answer 18

• 30 items or UE physical function
• scoring formulas: a higher score indicates greater diability

Question 19

Quick DASH

Answer 19

• 11 items of UE physical function
• total score out of 100 is calculated
• higher score indicates greater dsiability

Question 20

Lysholm knee scale

Answer 20

• section on limp, support device, locking, instability, stair climbing
• lower score = greater disbaility

Question 22

Cincinnati Knee rating system

Answer 22

• good for active people
• higher score = less disbaility
• 2 categories:
  1) symptom category: score pain, swelling, stability
  2) functional activity category: overal acitvity level, walking, stairs, running, jumpping, twisting

Question 23

WOMAC- Western Ontario and McMaster University

Answer 23

• three subscales: pain, stiffness, functional difficulty
• sum score from each subscore
• higher score indiciates more pain, stiffess, and disability

Question 24

KOOS Knee survey

Answer 24

• based off WOMAC
• arthritis/joint conditions, sports and musculo injury (meniscal, ACL, articular cartilage, joint arthroplasty, fx)
• 42 items
• subscales: pain, symptoms, ADLs, sports and recreation, quality of life

Question 25

LEFS - LE functional scale

Answer 25

• 5 point scale
• highest possible score is 80
• higher score = higher function

Question 26

Functional tests as outcome measures

Answer 26

• berg balance
• tinetti
• 6 minute walk test
• TUG
• self paced walk
• stair measure

Question 27

Measure of community ambuation after stroke

Answer 27

• velocity: 2.5-5 ft/sec
• endurance: able to walk 1089-1640 ft
• step up onto a curb: 22 cm

These are requirements for community ambulation

Question 28

Functional movement screen (FMS)

Answer 28

• screen movemetns related to jobs
• often done on athletes, firefighters, military
• perform 7 tests each on a 0-3 score
• total score range 0-21
• score <14 may be predictive of MSK injruy inconculsion as to exact amount of risk, type of injury, cut off score for different populations future studies needed

Question 29

Parts of the FMS

Answer 29

• lunge
• hurdel step
• squat
• quadruped
• active SLR
• shoulder mobility

Question 30

Functional capacity evaulation FCE

Answer 30

• series of performance tests to determine:
• capabilities and tolerane for work readiness
• documentation for diability eligibility
• ono-occupational functional abilities/ADLs

Question 31

FCE: evaulation of clients…?

Answer 31

• ROM
• strength/endurance
• walking/gait
• lifting, carying etc abilities
• positional tolerances
• coordination/dexterity
• consistency of performance
  document client responses during testing - pain status, perceived exertion, vitals

Question 32

FCE types

Answer 32

• job specific
• general FCE

Question 33

Job specific FCE

Answer 33

• ability to perfom required job specific physical tasks
• lifting, carrying, pushing/pulling, climbing, positional tolerances using provided specifications/methods
• work-site: in-clinic job task simulation with provided tools, parts etc

Question 34

General FCE

Answer 34

• when a job specific FCE is not provided/required
• tests general typical tasks –lifting, carrying, pushing etc
• when ADL specific tasks are not rovided
• tests general ADLs

Question 35

FCE testing: a person’s physical demand level

Answer 35

• sedentary
• light
• medium
• medium heavy
• heavy
• very heavy