Physiotherapy Outcome Measures
Physiotherapy uses objective outcome measures to provide reliable and credible information used to determine treatment progress and efficacy.
Barthel ADL Index
The Barthel ADL Index assesses a patient’s ability to perform Activities of Daily Living (ADLs) by using a 10-item index that addresses changes in a patient’s functionalities in daily activities. This measure is used for individuals that have experienced stroke, are patients of rehab, skilled nursing settings, and nursing homes.
Credit: Mahoney FI, Barthel D. “Functional evaluation: the Barthel Index.” Maryland State Med Journal 1965;14:56-61. Used with permission. Provided by the Internet Stroke Center — www.strokecenter.org
Download: Barthel ADL Index
Berg Balance Scale
The Berg Balance Scale (BBS) is a 14-item scale that assesses a patient’s ability to balance safely in a variety of predetermined tasks. It is used mainly for the elderly population that have balancing impairments as well as patients with acute stroke.
Berg K, Wood-Dauphinee S, WilliamsJI, Maki, B: Measuring balance in the elderly: Validation of an instrument. Can. J. Pub.Health, July/August supplement 2:S7-11, 1992. Provided by the Internet StrokeCenter — www.strokecenter.org
Berg K et al (1995) The Balance Scale: reliability assessment for elderly residents and patients with an acute stroke Scandinavian Journal of Rehabilitation Medicine 27, 27-36
Download: Berg Balance Scale
The Disability of the Arm, Shoulder, and Hand (DASH) questionnaire measures the interference or difficulty of a patient’s upper extremities in performing everyday activities (e.g. making one’s bed, preparing a meal). It is a 30-item questionnaire meant for patients with one or more musculoskeletal disorder(s) of the upper extremities.
Credit: Beaton D.E., Katz J.N., Fossel A. H., Wright J.G., Tarasuk V., Bombardier C. Measuring the whole or the parts? Validity, reliability, and responsiveness of the Disabilities of the Arm, Shoulder and Hand outcome measure in different regions of the upper extremity. J Hand Ther. 2001; 14(2): 128-146.
The DASH outcome measure. Available at http://www.dash.iwh.on.ca, Accessed November 28, 2015.
Download: DASH Questionnaire
The QuickDASH questionnaire is a modified version of the Disability of the Arm, Shoulder, and Hand questionnaire (DASH) that makes use of an 11-item scale (as opposed to the 30-item version). It measures the patient’s ability to perform everyday activities with their arm, shoulder, and hand.
Credit: Gummesson C., Ward M.M., Atroshi I. The shortened disabilities of the arm, shoulder and hand questionnaire (QuickDASH): validity and reliability based on responses within the full-length DASH. BMC Musculoskeletal Disorders. 2006; 7(44): 1-7.
Download: Quick Dash Questionnaire
Fear Avoidance Beliefs Questionnaire
The Fear Avoidance Beliefs Questionnaire is a tool used to determine a patient’s level of fear and subsequent avoidance of performing physical activity. Individuals with higher scores of fear have a tendency to have prolonged and more chronic conditions (whereas those with lower scores end up with the acute variety). This is useful in identifying patients with Lower Back Pain (LBP) who are not able to return to work by four weeks.
Credit: Waddell G, Newton M, Henderson I, Somerville D, M Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain 1993; 52:157-168 Fritz JM, George S. Identifying Psychosocial Variables in Patients With Acute Work-Related Low Back Pain: The Importance of Fear-Avoidance Beliefs. Phys Ther. 2002; 82(10): 973-983.
Download: Fear Avoidance Belief Questionnaire
Fatigue Severity Scale
The Fatigue Severity Scale is a scale that measures the severity of a patient’s fatigue and the extent to which it affects a patient’s daily activities. It is a 9-item scale that is intended for individuals who experience disorders such as arthritis, stroke, multiple sclerosis, Parkinson’s Disease, and fibromyalgia.
Credit: Garber, C. E. and Friedman, J. H. (2003). “Effects of fatigue on physical activity and function in patients with Parkinson’s disease.” Neurology 60(7): 1119-1124.
Download: Fatigue Severity Scale
Fibromyalgia Impact Questionnaire
The Fibromyalgia Impact Questionnaire (FIQ) assesses the health components most impacted by Fibromyalgia (FM) in a patient with FM. It is a 20-item scale that measures the patient’s status, progress throughout the condition, and outcome.
Credit: Burckhardt CS, Clark SR, Bennett RM.The fibromyalgia impact questionnaire: development and validation.J Rheumatol. 1991 May;18(5):728-33
Download: Fibromyalgia Impact Questionnaire (FIQ)
Foot Function Index
The Foot Function Index (FFI) is a 23-item index that measures foot functionality and pathology based on a pain, disability, and activity limitation subscale. It is a tool used for low-functioning individuals with foot disorders or patients with rheumatoid arthritis.
Credit: Budiman-Mak E, Conrad KJ, Roach KE. The Foot Function Index: a measure of foot pain and disability. J Clin Epidemiol. 1991;44:561–570.
Martin RL, Irrgang JJ. A survey of self-reported outcome instruments for the foot and ankle. J Orthop Sports Phys Ther.2007;37:72–84.
Download: Foot Function Index
HOOS Hip Survey
The HOOS Hip Survey is an instrument that is used to assess the patient’s’ view about their hip. It helps to keep track of how the patient feels about their hip and how well they are able to do their normal activities. HOOS is designed for hip disability with or without osteoarthritis. This survey contains questions that are divided into six subcategories including symptoms, stiffness, pain, function in daily activity, function in sports and recreational activities and impact on quality of life. The outcomes of the last week are taken into consideration and the survey can be used for both short and long term time intervals in order to evaluate changes induced by treatment.
Credit: Klassbo M, Larsson E, Mannevik E. Hip disability and Osteoarthritis Outcome Score. An extension of the Western Ontario and McMaster Universities Osteoarthritis Index. Scand J Rheumatol. 2003;32(1):46-51.
KOOS Knee Survey
The KOOS Knee Survey is an instrument used to assess the patient’s view about their knee. It helps to keep track of how the patient feels about their knee and how well they are able to do their normal activities. KOOS is designed for knee injury that can result in post traumatic osteoarthritis, but can also be used in knee osteoarthritis. This survey contains questions that are divided into six subcategories including symptoms, stiffness, pain, function in daily activity, function in sports and recreational activities and impact on quality of life. The outcomes of the last week are taken into consideration and the survey can be used for both short and long term time intervals in order to evaluate changes induced by treatment.
Credit: Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD. Knee Injury and Osteoarthritis Outcome Score (KOOS)–development of a self-administered outcome measure. J Orthop Sports Phys Ther. 1998 Aug;28(2):88-96.
Low Back Pain and Disability Questionnaire (Revised Oswestry)
The Low Back Pain and Disability Questionnaire is a tool used to assess the effect of low back pain on a patient’s ability to manage everyday activities. The questionnaire contains ten categories concerning pain intensity, personal care, lifting, walking, sitting, standing, sleeping, social life, travelling and changing degree of pain. The amount of disability from low back pain during each activity is evaluated.
Credit: Fairbank JC, Couper J, Davies JB, O’Brien JP. The Oswestry low back pain disability questionnaire. Physiotherapy. 1980 Aug;66(8):271-3.
Download: Low back Oswestry questionaire
Lower Extremity Functional Scale
The Lower Extremity Functional Scale (LEFS) is a self-report measure used to track the status, progress, and outcome of a variety of lower extremity conditions in adults.
Credit: Binkley JM, Stratford PW, Lott SA, Riddle DL. The lower extremity functional scale (LEFS): scale development, measurement properties, and clinical application. Phys Ther 1999;79:371-383.
Download: Lower Extremity Functional Scale
McMaster Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR)
The McMaster Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR) is an approach used to measure the change in impaired activities selected by the patient during a baseline interview and change in rheumatoid arthritis disease activity.
Credit: Verhoeven, A.C., Boers, M., Van der Liden, S. (2000). Validity of the MACTAR questionnaire as a functional index in a rheumatoid arthritis clinical trial.
The McMaster Toronto Arthritis. Journal of Rheumatology, 27(12), 2801-9.
McGill Pain Questionnaire and Pain Diagram (Short Form)
The Short Form McGill Pain Questionnaire and Pain Diagram is a short form of the McGill Pain Questionnaire. It is a self-report measure used to assess the quality and intensity of pain, as well as to monitor the pain overtime and evaluate the effectiveness of any treatment. This version of the questionnaire consists of 15 descriptors which are rated on an intensity scale with the options of mild, moderate or severe pain. A diagram is also included to mark the areas affected by pain.
Citation: Melzack, R. (n.d.). The short-form McGill pain questionnaire. Pain, 191-197.
Download: McGill Pain Questionnaire (Short Form)
Neck Pain and Disability Index (Vernon Mior)
The Neck Pain Disability Index is a tool used to assess the effect of neck pain on a patient’s ability to manage everyday activities. The questionnaire contains ten categories concerning pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping and recreation. The amount of disability from neck pain during each activity is evaluated. This questionnaire is commonly peformed on patients who are attending Physiotherapy for Car Accident.
Citation: Vernon HT, Mior SA. The Neck Disability Index: a study of reliability and validity. J Manip Physiol Ther 1991;14:409-415.
Pain Catastrophizing Scale (PC Scale)
The PC Scale is a comprehensive 13-item evaluation instrument that incorporates different perspectives on catastrophizing of pain. The questionnaire requires the individual to reflect on past painful experiences and to specify the degree to which they experienced certain thoughts and feelings when they were in pain. The PC Scale is unique compared to other pain-related measurement tests, is it does not require the individual to be in pain while completing the questionnaire.
Citation: The Pain Catastrophizing Scale: Development and validation. Sullivan, M.J.L., Bishop, S.R., Pivik, J. (1995) Psychological Assessment; 7: 524-532.
Download: Pain Catastrophizing Scale
Roland-Morris Disability Questionnaire
The Roland-Morris Disability Scale is a self-report measure that inquires about physical disabilities that are associated with lower back pain. It is a measure best intended for those with mild-to-moderate disabilities.
Credit: Roland M, Fairbank J. The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. Spine 2000;25(24):3115-24
Download: Roland-Morris Disability Questionnaire
WOMAC Osteoarthritis Index
The WOMAC (Western Ontario and McMaster Universities) Osteoarthritis Index is a 24-item scale that evaluates Hip and Knee Osteoarthritis by assessing three dimensions of impairment: pain, stiffness, and physical functionality.
Credit: American College of Rheumatology. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). http://www.rheumatology.org/practice/clinical/clinicianresearchers/outcomes-instrumentation/WOMAC.asp. (accessed 05 December 2015).
Download: WOMAC Osteoarthritis-Index
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