assessing disability and change on individual patients: a report of a patient specific measure.

Are self-report measures of disability reliable for persons with neck dysfunction?

Self-report measures of disability are being used more frequently to assess patients' outcomes in clinical practice. This study examines the reliability, validity, and sensitivity to change of the Patient-Specific Functional Scale when applied to persons with neck dysfunction.

How do patients rate ability to complete an activity?

Patients rate their ability to complete an activity on an 11-point scale at a level experienced prior to injury or change in functional status. "0" represents “unable to perform.” "10" represents “able to perform at prior level.” Patients select a value that best describes their current level of ability on each activity assessed.

How is the patient-specific functional scale and neck disability index applied?

The Patient-Specific Functional Scale and Neck Disability Index were applied at the initial visit, within 72 hours of the initial visit, and following 1-4 weeks of treatment in 31 patients with cervical dysfunction. At the time of the initial visit, the clinician made an estimate of patients' prognoses on a five-point scale.

What does the patient specific functional scale measure?

The PSFS is a valid, reliable, and responsive outcome measure for patients with back, neck, knee and upper extremity problems. It has also been shown to have a high test-retest reliability in both generic lower back pain and knee dysfunction issues.

How do you score Psfs?

Remember that on the PSFS scale, zero is the worst score (the patient cannot perform the activity) and 10 is the best score (the patient is able to perform the activity at the same level as before the injury or problem). This is the opposite of the VAS scale of pain.

What is a functional scale?

The Patient-Specific Functional Scale. This useful questionnaire can be used to quantify activity limitation and measure functional outcome for patients with any orthopaedic condition. Clinician to read and fill in below: Complete at the end of the history and prior to physical examination.

What is the DASH outcome measure?

The Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Measure is a 30-item, self-report questionnaire designed to measure physical function and symptoms in patients with any or several musculoskeletal disorders of the upper limb.

What is patient specific?

(pā′shĕnt-spĕ-sif′ik) Customized to the precise anatomy, physiology, or health care needs of one person.

What is ABC scale?

The ABC Scale is a self-report measure of balance confidence in performing various activities without losing balance or experiencing a sense of unsteadiness.

What is neck disability index?

The Neck Disability Index (NDI) is a 10-item questionnaire that measures a patient's self-reported neck pain related disability. It was the first of its kind when it was published in 1991 in JMPT and was based on the Oswestry Low Back Pain Disability Questionnaire.

What is the functional reach test?

The FRT assesses a patient's stability by measuring the maximum distance an individual can reach forward while standing in a fixed position. The modified version of the FRT, requires the individual to sit in a fixed position.

Objective

Patient Specific Functional Scale was developed by Stratford et al 1995 as a self-report outcome measure of function that could be used in patients with varying levels of independence.

Intended Population

The PSFS is a self-reported valid, reliable, and responsive outcome measure for patients with back, neck, knee and upper extremity problems. It has also been shown to have a high test-retest reliability in both generic lower back pain and knee dysfunction issues. It is also clinically responsive to changes over time with chronic pain patients

Method of Use

Patients are asked to identify up to five important activities they are unable to perform or are having difficulty with as a result of their problem eg putting socks on, shopping.

Evidence

The PSFS is a valid, reliable, and responsive outcome measure for patients with back, neck, knee and upper extremity problems. It has also been shown to have a high test-retest reliability in both generic lower back pain and knee dysfunction issues.

Method

The current study represents a secondary analysis of data obtained from an investigation that examined patient outcomes with a new class-based model of care that involved a series of structured exercise classes for patients post-TKA. Each class lasted approximately 90 minutes, and participants typically attended 10 classes over 5 weeks.

Results

Participants were 133 patients with a mean age of 68.0 years (SD=8.4). Eighty-seven participants were female. The median initial and follow-up assessments occurred 14 days (1st, 3rd quartiles=11, 17) and 51 days (1st, 3rd quartiles=46, 58) postarthroplasty.

Discussion

The goal of this study was to provide information concerning the ability of the PSFS to detect improvement in patients post-TKA. Patients were assessed within 80 days of arthroplasty, and the LEFS scores and change scores of our sample were consistent with those reported previously.

Author notes

All authors provided concept/idea/research design and writing. Ms Kennedy and Ms Wainwright provided data collection, project management, study participants, facilities/equipment, and institutional liaisons. Mr Stratford provided data analysis. Mr Stratford and Ms Kennedy provided consultation (including review of manuscript before submission).

Objective

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Intended Population

Method of Use

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