Outcome Measures

Question 1

Define an outcome measure

Answer 1

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.

Question 2

What should an outcome measure be?

Answer 2

Standardised
Reliable
Valid
Acceptable 
P should be responsive

Question 3

MRC Grading

Grade 0

Answer 3

No contraction

Despite the patient co operating with the instruction, there is no visible or palpable muscle contraction

Question 4

MRC Grading

Grade 1

Answer 4

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

Question 5

MRC Grading

Grade 2

Answer 5

Can move through full available range with gravity counterbalanced
PROM should be equal to AROM with gravity counterbalanced

Question 6

MRC Grading

Grade 3

Answer 6

Can move through the full available range against gravity and with a hold
PROM should be equal to AROM against gravity

Question 7

MRC Grading

Grade 4

Answer 7

Using resistance eg. a light hand/ankle weight, can qualify this more

Question 8

MRS Grading

Grade 5

Answer 8

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.

Question 9

ROM assessment

Answer 9

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

Question 10

Goniometry

- Used for?

Answer 10

Joint movements
Use bony landmarks to determine placement of the axis
Zero degrees is usual ply position of joint in anatomical position.

Question 11

Goniometry

- Procedure?

Answer 11

• Select right size of goniometer. Measure unaffected before affected
• Estimate available ROM, ready to read of goniometer
• Position incorrect

Question 12

Peak Expiratory Flow Rate (PEFR)

- Used for?

Answer 12

Measure maximum expiratory flow rate - fastest patient can breathe out in a second.
Commonly used for asthma.
Normal is 400-650L/min

Question 13

Peak Expiratory Flow Rate (PEFR)

- Procedure?

Answer 13

• 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

Question 14

Balance testing

- Used for?

Answer 14

Assess and monitor progression of static standing balance
All completed for 60 seconds.
Consider safety at all times

Question 15

Balance testing

- Eyes open test

Answer 15

1. Stand on one leg, arms across chest.
2. Legs not touching
3. 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

Question 16

Balance testing

- Eyes closed test

Answer 16

1. 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.

Question 17

Figure of 8

- Used for

Answer 17

• Assessing and quantifying ankle oedema
• Perform on unaffected then affected side
• P long sitting and knees extended, ankle neutral

Question 18

Figure of 8

- Landmarks

Answer 18

Marks the anatomical landmarks:

• Tuberosity of navicular
• Base of 5th metatarsal
• Tip of medial malleolus
• Tip of lateral malleolus
• Tibialis anterior tendon

Question 19

Figure of 8

- Procedure

Answer 19

1. Place zero on the tape measure midway between the tib ant tendon and lat mall
2. Take tape medially across instep and inf to tub of nav
3. Bring tape across under med long arch and lat to prox to base of 5th met
4. Take tape measure around ankle to distal top of med mall and across achilles tendon towards tip of lat mall
5. Take tape measure back to 0
6. Record length in mm and take average of 2 readings.

Question 20

Timed Up & Go

- Used for?

Answer 20

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

Question 21

Timed Up & Go

- Procedure?

Answer 21

1. Start with back against chair and feet flat on the floor
2. 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”
3. Start timing using stopwatch when you say “Go”
4. Stop when P bottom sits back down on chair
5. Record time in seconds