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Functional outcome measures
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Functional outcome measures - August 4, 2008 6:56:58 PM
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elspt
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Joined: June 1, 2006
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I'm wondering if anyone has suggestions for objective functional outcome measures. For example, I just started using the DASH (Disabilities of the Arm, Shoulder, and Hand) and the LEFS (Lower Extremity Functional Scale). Both are fairy quick. The LEFS has 9 points for a minimum significant level of change. I know it's easier (and faster) to just write in subjective improvments in my notes, but I know that insurance companies are moving more and more to a demand for objective improvements. Also, I'd like to track my own success with different patient populations.
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RE: Functional outcome measures - August 4, 2008 7:23:03 PM
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blast7
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I use the ones you mentioned as well as UE Functional Scale, Oswestry for Low Back, Neck Disability Index and ASES.
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RE: Functional outcome measures - August 5, 2008 9:34:03 AM
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ptim
Posts: 68
Joined: September 26, 2006
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check out FOTO www.fotoinc.com
There software contains most outcome tools, and you can pick and choose which ones you want.
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RE: Functional outcome measures - August 5, 2008 1:35:40 PM
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torques
Posts: 59
Joined: July 18, 2008
From: Marion, IN
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Hi ELSPT,
In the clinics, I use Patient-specific Functional Scale with all my patients. 2 points MDIC for average score and 3 points for single activity score. I love this because it is generic and reflects patient's own disability. I supplement this with Oswestry neck/back index + Fear avoidance Belief Questionnaire (to give me an idea about patient's perception of pain with regards to activities). For extremities: LEFS and UEFS. SPADI for shoulder. I have them fill out the form in 2 or 4 weeks. These outcome measure should be backed up with changes in impairments/dysfunctions. Improvement in impairments should equate clinically meaningful change in functional outcome. Measuring impairments is always a challenge since gamut of tests are out there. I like to be specific in hypothesizing what impairments are relevant. [I tend to be more mechanistic in my assessment approach although I incorporate gross functional strategies in my treatment (influence of Gary Gray).] Here is where research comes to play. There are few tests/procedures that have acceptable validity. But it you get a chance to find these measures, use it in your practice. I read and subscribe to PT Bulletin, JOSPT and AAOMPT journals. Great source for PT data you need.
Julius Quezon, PT MTC CPed
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RE: Functional outcome measures - August 5, 2008 6:14:33 PM
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Tom Reeves DPT ATC
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I use the Oswestry for back pain/dysfunction. Also quick, only 10 questions. Some people can't seem to pick the best answer but that will be the case with any outcome measure.
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RE: Functional outcome measures - August 5, 2008 6:28:02 PM
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TexasOrtho
Posts: 556
Joined: December 22, 2007
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I use LEFS, DASH, Oswestry, Neck Disability Index. I love and hate them for various reasons. I really like the SPADI for shoulder dysfunction because it's quick and easy.
_____________________________
Rod Henderson, PT
Board Certified Orthopedic Specialist (or Super-Freak)
Certified Strength and Conditioning Specialist
www.texasorthopedics.blogspot.com
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RE: Functional outcome measures - August 5, 2008 10:03:27 PM
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SJBird55
Posts: 2438
Joined: May 10, 2004
From: Michigan
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Elspt, if you happen to plan on attending the Combined Sections Meeting in February in Las Vegas in 2009, I am very sure that there will be a session on outcome tools, assessing outcomes and what you can learn from assessing your outcomes. JW Matheson and Michael Ross will be 2 of the presenters.
Previous responders gave good advice with respect to outcome tools. Tracking your own outcomes is another topic. ;)
Hey, blast7, what is the ASES? I'm assuming it is an acronym versus a misspelling. ;)
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RE: Functional outcome measures - August 6, 2008 12:53:59 AM
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blast7
Posts: 114
Joined: July 28, 2005
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Woops, I wrote the other ones out except for this one. American Shoulder and Elbow Surgeons Scale.
quote:
ORIGINAL: SJBird55
Elspt, if you happen to plan on attending the Combined Sections Meeting in February in Las Vegas in 2009, I am very sure that there will be a session on outcome tools, assessing outcomes and what you can learn from assessing your outcomes. JW Matheson and Michael Ross will be 2 of the presenters.
Previous responders gave good advice with respect to outcome tools. Tracking your own outcomes is another topic. ;)
Hey, blast7, what is the ASES? I'm assuming it is an acronym versus a misspelling. ;)
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RE: Functional outcome measures - August 6, 2008 8:08:34 PM
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pdtoal
Posts: 26
Joined: September 13, 2007
Status: online
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I'm in the process of trying to use some of the above mentioned outcome measures. One question I have is in regards to copyrighting and if permission needs to be obtained to use them?
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RE: Functional outcome measures - August 6, 2008 9:44:34 PM
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SJBird55
Posts: 2438
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From: Michigan
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pdtoal
You can find these tools and download them and use them:
LEFS
ODI
NDI
PF-10
SPADI
There is also a Foot Function Index
There is also a Knee Outcome Index (I can't remember if that is the actual name.. hmmm)
I used to use the DASH and switched to the Quick DASH. To use the DASH or Quick DASH you actually need to register information about yourself, but it is free.
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RE: Functional outcome measures - August 6, 2008 9:51:30 PM
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pdtoal
Posts: 26
Joined: September 13, 2007
Status: online
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Thanks, SJ.
I'm considering the DASH but it seems a bit long. I'm going to start looking, but do you know if there is an MDIC for the quick DASH?
Phil
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RE: Functional outcome measures - August 6, 2008 10:11:27 PM
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SJBird55
Posts: 2438
Joined: May 10, 2004
From: Michigan
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From: http://www.dash.iwh.on.ca/faq.htm
quote:
Q. What is considered to be a clinically important change for the QuickDASH?
A. At present, we do not have values for the Minimal Detectable Change (MCD) or Minimal Clinical Important Difference (MCID) for the QuickDASH that have specifically been validated. We do have the reliability coefficeients (ICC = 0.94) which would result in a MDC95 = 15.8 and MDC90 =13.2 based on a standard deviation of 23.2. MCID will vary depending on method, and by and large will approximately equal or be less that the MDC95. As such, the MDC95 could be a reasonable surrogate.
Comparison of Quick DASH to DASH: http://www.biomedcentral.com/content/pdf/1471-2474-7-44.pdf
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