Outcome Measures

Question 1

• OMs are used to document progress and must demonstrate

Answer 1

– departure from wellness

– progress

Question 2

• With documented progress OMs must show

Answer 2

– that treatment is effective, reasonable,

and necessary

Question 3

• In absence of documented progress

Answer 3

– Treatment is deemed ineffective,

unnecessary, unreasonable

Question 4

What do you want to measure?

Answer 4

– Pain 
– Mental status
– Disability 
– Satisfaction with care
– Health status 
– Work status

Question 5

How do you pick a measure?

Answer 5

– Valid - Does it measure what supposed to?
– Reliable - dependable?
– Responsive - Can measure differences over time?

Question 6

– 10 cm line
– Instructions:
Please make vertical mark on the line below to indicate your level of pain today.

Answer 6

Visual Analog Scale (VAS)

Question 7

Circle the number of pain 0-10

Answer 7

Numeric Pain Rating Scale NRS

Question 8

• Pain Right Now?
• Typical or Average Pain?
• Pain At It’s Best?
• Pain At It’s Worst?

Answer 8

Quadruple VAS

Question 9

• Ability of a person to
perform common activities of daily living.
• Measure of function.

Answer 9

Disability

Question 10

• Low back disability
• 10 sections of daily activities
– Pain Intensity, personal care, walking, social life…
• 6 choices each section
• Scored 0-5
• Add each section for over-all disability
– Greatest disability = 50
– or Xby 2 for % score

Answer 10

Oswestry Disability index (ODI)

Question 11

• Low back disability
• 24 disability statements
• Score: total number of statements marked

Answer 11

Roland Morris Questionnaire (RMQ)

Question 12

• 7 Items
• Each is a scale of 0 to 10
• Take total points and divide by 70 for % disability

Answer 12

Bournemouth Low Back and

Bournemouth Neck Questionnaires

Question 13

– 20 Items scored 0 – 4

– Total score / 80 x 100 = % disability

Answer 13

Upper Extremity Functional Index (UEFI)

Question 14

• 2 subscales
– Emotional and Functional
• Plus Total Composite score

Answer 14

Headache Disability Index

Question 15

• Similar to Upper Extremity Functional
Index (UEFI)
– 20 Items scored 0 – 4
– Total score / 80 x 100 = % disability

Answer 15

Lower Extremity Functional Scale (LEFS)

Question 16

• Health Status Questionnaire (HSQ 36, or SF 36)
– 8 Subscales of general health
• Physical Functioning, Role Physical, Bodily Pain,
General Health, Vitality, Social Functioning, Role
Emotional, Mental Health
– 2 Summary Measures
• Physical, Emotional Health
– Overall score
– 3 Individual diagnostic questions
• Complex to score

Answer 16

General Health Status

Question 17

• Fear Avoidance Beliefs Questionnaire
– Measures beliefs about activity and pain in
normal activity and work
• Modified Work APGAR
– Questions about job tasks and interpersonal
relationships on the job rated “almost always”
“some of the time” and “hardly ever”
– Those who “hardly ever” enjoyed their job
tasks were 2.5x more likely to have back
injuries than almost “always enjoyed” their job
tasks

Answer 17

Yellow Flag Outcomes

Psychosocial Outcomes

Question 18

1. Superficial or Non-anatomic Tenderness
2. Simulation
   – LBP with axial loading or standing rotation of the shoulders and pelvis
3. Distraction
   – 40o-45o difference Supine SLR to Sitting SLR
4. Regional disturbances
   – Unexplained weakness or sensory findings
5. Over-reaction
   – Exaggerated responses to testing

Answer 18

Waddell’s Signs

Question 19

• Pain outside the
body
• Pain in all 4 extremities
• Multiple types of pain qualities
– Aching, burning,
stabbing, numbness,
pins & needles

Answer 19

Pain Diagram “Yellow Flags”