Outcome Measures Flashcards
Define an outcome measure
In physiotherapy an outcome measure is something used to accurately measure an aspect of a patient’s problem which may be improved by the therapist’s treatment.
It is used to determine whether or not treatment is being effective.
What should an outcome measure be?
Standardised Reliable Valid Acceptable P should be responsive
MRC Grading
Grade 0
No contraction
Despite the patient co operating with the instruction, there is no visible or palpable muscle contraction
MRC Grading
Grade 1
Flicker of contraction
Some muscle contraction is seen and/or palpated but patient is unable to move through full available range even with gravity counterbalanced
MRC Grading
Grade 2
Can move through full available range with gravity counterbalanced
PROM should be equal to AROM with gravity counterbalanced
MRC Grading
Grade 3
Can move through the full available range against gravity and with a hold
PROM should be equal to AROM against gravity
MRC Grading
Grade 4
Using resistance eg. a light hand/ankle weight, can qualify this more
MRS Grading
Grade 5
Can move through full available range against a maximal resistance
Maximal resistance can be provided by a heavy hand/ankle weight, the therapist or the patients own body weight.
Grade 5 can also be defined as normal function.
ROM assessment
Unclothe adequately
Starting position allows joint positioned at zero
Perform movement slowly
Observe movement and estimate joint range
Measure unaffected side first
Then affected side more than once
Goniometry
- Used for?
Joint movements
Use bony landmarks to determine placement of the axis
Zero degrees is usual ply position of joint in anatomical position.
Goniometry
- Procedure?
- Select right size of goniometer. Measure unaffected before affected
- Estimate available ROM, ready to read of goniometer
- Position incorrect
Peak Expiratory Flow Rate (PEFR)
- Used for?
Measure maximum expiratory flow rate - fastest patient can breathe out in a second.
Commonly used for asthma.
Normal is 400-650L/min
Peak Expiratory Flow Rate (PEFR)
- Procedure?
- Explain to P the purpose and obtain consent
- Attach clean mouthpiece
- Set to 0 and sit patient upright.
- Ask P to take in maximal inspiration and close lips around mouthpiece and exhale as forcibly as possible
- Note down and repeat 2x.
- Dispose mouthpiece.
- Highest value of the 3 and compare against charts
Balance testing
- Used for?
Assess and monitor progression of static standing balance
All completed for 60 seconds.
Consider safety at all times
Balance testing
- Eyes open test
- Stand on one leg, arms across chest.
- Legs not touching
- Look straight ahead with eyes open and focus on object about 3 feet in front.
> Stop timing if: legs touch, feet touch floor, foot on floor moves, arms moved from start position
Balance testing
- Eyes closed test
- Stand on one leg, arms across chest, legs not touching. Close eyes.
> Stop timing if: legs touched each other, feet moved from floor, foot touches ground, eyes opened, arms moved.
Figure of 8
- Used for
- Assessing and quantifying ankle oedema
- Perform on unaffected then affected side
- P long sitting and knees extended, ankle neutral
Figure of 8
- Landmarks
Marks the anatomical landmarks:
- Tuberosity of navicular
- Base of 5th metatarsal
- Tip of medial malleolus
- Tip of lateral malleolus
- Tibialis anterior tendon
Figure of 8
- Procedure
- Place zero on the tape measure midway between the tib ant tendon and lat mall
- Take tape medially across instep and inf to tub of nav
- Bring tape across under med long arch and lat to prox to base of 5th met
- Take tape measure around ankle to distal top of med mall and across achilles tendon towards tip of lat mall
- Take tape measure back to 0
- Record length in mm and take average of 2 readings.
Timed Up & Go
- Used for?
Measure of functional mobility
Particularly with elderly populations and identifies Ps who are at risk of falling
Set up chair with line on floor 3 metres away
Ps wear usual footwear and usual WA
Untimed practice attempt then timed attempt
Timed Up & Go
- Procedure?
- Start with back against chair and feet flat on the floor
- Say to the P “When I say go, I want you to stand up from the chair, walk to the line on the floor at normal pace, turn and walk back to the chair then sit down”
- Start timing using stopwatch when you say “Go”
- Stop when P bottom sits back down on chair
- Record time in seconds
