Function and Disability w/ Self-Report Outcome Tools for Pts w/ Spinal Conditions Flashcards
SRO
self-reports
3 components:
- Pain
- Functional Limits
- Disability
For SRO tool to have clinical utility
Psychometric props must be known:
what are they?
- validity→ does it measure what I want it to?
- reliability→ if I do it again w/ someone else will it tell me the same result?
- Error and accuracy
- responsiveness to change
Using SRO’s
w/ indiv. pts
- @ initial visit
- baseline
- establishes goals/outcomes
- repeat @ follow-up/re-exam
- monitors change (improve or deterioration
- repeat @ time of discharge
- doc. outcomes following course of care
Use of SRO’s
Assessing performance of clinics or clinicians
compare groups of pts across:
- facilities (loc’s)
- different PTs or teams
- Pts w/ certain dis’s or patho’s such as LBP
Use of SRO’s
in Research Applications
- Pre/Post intervention measures
- Descriptive studies
Standard Error of Measurement (SEM)
SEM (95% CB) ==>
Error in single day’s score
EX. SEM of Roland-Morris
Roland-Morris SEM (95% CB)= ±3 pts
- Helens score on the Roland-Morris is 20pts
- Accounting for measurement of error, we can be reasonably confident that her “true score” lies b/w 17 and 23
*NOTE: when you know the SEM (95% CB), just ADD/SUBTRACT that value from the score. You can be 95% confident that their “true score” @ a given point in time lies w/in the calculated range
Minimal Detectable Change
MDC (95% CB)
Used to determine clinical meaningfulness of change over time
EX. MDC of Roland-Morris
Roland-Morris MDC (95% CB)= 5pts
- after 3wks of PT, Helen is again asked to complete Roland-Morris. Her score has changed and is now 13 (7 pts LESS than her score 3wks ago)
- we can be reasonably confident that Helen’s change in score reflects TRUE improvement in her status, bc it has improved by MORE than the MDC of 5pts***
*NOTE: When you know the MDC (95% CB) of a SRO tool, you can be reasonably confident that the pt has truly improved (or worsened) if their follow-up score has changed by the MDC value or more.
Minimally Clinically Important Difference
MCID
- used SAME WAY as the MDC
- det’s change in pts status over time
- Methodological research to det. MCID value is a bit diff than that used to det. MCD value
- IF BOTH MCD and MCID values are known, you can use either!
- Usually, the MCD and MCID values are pretty similar
For pts w/ LBP or Disability:
Roland-Morris Questionnaire
see pics
Roland-Morris Disability
Take-aways
0= NO DISABILITY
24= SEVERE DISABILITY
Pts w/ LBP or Disability
Revised Oswestry
- 10 sections, 6 options ea.
- 0 pts for 1st option, 1 pt for 2nd option, 2pts for 3rd, etc
- Tally and multiply sum by 2
- Scale 0-100%
- 0%= NO DISABILITY
- Completion= 5mins
- Score time= 1 min
For pts w/ Neck Pain or Disability
Neck Disability Index (NDI)
- 10 sections, 6 options per ea.
- 1st option= 0 pts, 2nd option=1 pt, etc..
- Sum points
- Scale: 0-50 (or, convert to %→ NOTE THIS)
- 0=NO DISABILITY
- Scoring time=1min
Fear Avoidance Behavior Questionnaire
FABQ
- Not really a tool for function or disability
- More of a prognostic tool to ID yellow flags of fear or avoidance
- BUT, can be used @ follow up to see if pts are having LESS fear or LESS avoidance
Pts w/ any type of problem:
Patient Specific Functional Scale
PSFS
Pts ID the problems!!!
- Pt IDs up to 5 functional acts
-
Scale:
- 0= unable to perform
- 10= no diff performing
-
Scoring:
- calculate avg scores of items
- 3-5mins to complete
MDC for avg score= 2 pts; MDC for single item= 3 pts
For pts w/ any type of problem
Global Rating of Change Scale
GROC
- Used @ time of re-exam to det. overall perception of improvement by pt
- fast & easy
- Does not req any scoring
