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Title: Rehabilitation Outcome Measures

Author: Emma Stokes
Publisher: Churchill Livingston; Number of pages: 189
Reviewed by: Phil Stevens, MEd, CPO, FAAOP

Today’s healthcare market is characterized by increasing interest and emphasis on outcome measures and the justification of provided services.As a result, many in the orthotic and prosthetic community will soon need to familiarize themselves with the terms and processes that make up this movement.This text by Emma Stokes, though obviously written for the physical therapy community, can provide orthotists and prosthetists with a concise introductory resource and a “tool box” to assist in the selection of outcome measures for various patient care scenarios.

In its brief introductory section, readers are exposed to some of the history and development of standardized outcome measures, the International Classification of Functioning, Disability and Health (ICF) as a guiding framework to the selection of outcome assessment tools, and broad discussions on why and how to implement appropriate outcomes assessment into clinical practice.

The second section of the text is devoted to a fairly concise review of the key statistical concepts associated with any given outcome measure.This is done through individual chapters devoted to reliability, validity, and measuring change respectively.These chapters move quickly from conceptual introductions to the practicalities of the various analyses that are used to establish the appropriateness of a given outcome measure as an assessment tool in a given patient care scenario.This includes the treatment of such things as kappa coefficients, intra-class correlations, internal consistencies, and standard errors of measure as well as the differences between content, criterion, and construct validities.

The third section represents the largest of the three and will likely be the most referenced for those seeking to actually implement outcomes measurement into clinical practice.In this “tool box” overview, the material is classified according to measures of mobility, physical activity, fatigue, and satisfaction.Each of these functional domains is treated in turn as an individual chapter, with each chapter comprising a review of the various outcome measures that have been developed and evaluated to perform assessments within each domain.Thus, a clinician interested in measuring mobility can find a description of the modified Emory Functional Ambulation Profile, any associated academic publications, the patient populations for which it was developed, its clinical utility, and what is required for its administration, its validities and reliabilities, and its ability to measure change.The same information is indexed for eight additional outcome measures which assess mobility.Similar information isincluded for five measures of physical activity, six measures of fatigue, six measures of patient satisfaction, and seven disease-specific measures.

The text concludes with a very thorough, lengthy appendix, broken down into the various functional domains described earlier (mobility, physical activity, fatigue, etc.), where the outcome measures introduced earlier are fully presented with respect to the instructions on their proper administration, their scoring, and in the case of survey instruments, their full original language.

Thus, the text represents an excellent single source for those clinicians interested in expanding their knowledge of established outcome measures or integrating outcomes assessment into their practice environments.

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