Wheelchair Related Outcome Measures

Original Editor - Your name will be added here if you created the original content for this page.

Top Contributors - Naomi O'Reilly and Amrita Patro  

Introduction

An outcome measure is any characteristic or quality measured to assess a patient’s status[1]. An outcome measure is the result of a test that is used to objectively determine the baseline function of a patient at the beginning of treatment. Once treatment has commenced, the same instrument can be used to determine progress and treatment efficacy. With the move towards Evidence Based Practice (EBP) in the Health Sciences, objective measures of outcome are important to provide credible and reliable justification for treatment. The instrument should also be convenient to use for the wheelchair service personnel and comfortable for the wheelchair user. An integral part of evaluating clinical practice is to objectively assess the intervention and measure it against a set of outcomes to determine its efficacy. [2] This means the wheelchair service personnel can ensure they are providing the most appropriate intervention that meets the goals and expectations of the wheelchair user, their family member/caregiver and the wheelchair service provision team.  

Considerations before Choosing an Outcome Measure

If you are considering using an outcome measure for a wheelchair user it is worth considering the questions posed on the Guide to Selecting Outcome Measures Physiopedia Page. At the very least you should consider these questions with your wheelchair user in mind.

Why Am I Using an Outcome Measure?

  • Am I trying to establish a baseline measure from which I can monitor changes over time for an individual user?
  • Am I trying to predict how the wheelchair is going to perform? 
  • Am I trying to evaluate the impact of a wheelchair, a wheelchair component or treatment programme on an individual or a group?
  • Am I trying to evaluate the needs of the wheelchair user attending my service?
  • Am I trying to evaluate how my service is responding to needs of the wheelchair user?

What Am I Aiming to Measure?

  • Impairments of Body Structure and Function?
  • Activity Limitations?
  • Participation Restrictions?
  • Quality of Life?
  • Something Else?

Have the Clinimetric Properties been Measured in a Population Similar to Mine?

  1. Is the Outcome Measure Reliable?
    • Do I know the rate of error detected with scores?
    • Do I know the minimum detectable change?
  2. Is the Outcome Measure Valid?
    • Does it measure what I want it to measure?
  3. Is the Outcome Measure Responsive to Change?
    • Is there a known minimum clinically important difference?

Other Considerations

Other considerations (Outcome Measures) may come into play when deciding which outcome measure to use:

Financial Considerations: 

  • What is the cost of this test?
  • Is a licence required?
  • Is equipment required? 

Therapist Implementation 

  • Is the measure easy for a clinician to conduct?
  • Is special training required/available?
  • Are there clear standardised instructions on how to carry out and score the measure?
  • How long does it take to carry out the measure?
  • How long does it take to record results?

Resources 

  • Is special equipment or are special forms required?
  • Is space sufficient for this measure to be carried out?

Wheelchair User

  • How much time does it take for the person to complete?
  • Is the task difficult?
  • Is privacy required?

Patient-Reported Outcome Measures (PROQ) 

  • Is face-to-face contact required or can this measure be completed in the waiting room?
  • Does the questionnaire cover sensitive personal issues?
  • Is there a specific reading level required?
  • Is the measure available in other languages?

Sub Heading 2

References

  1. Fetters L, Tilson J. Evidence based physical therapy. FA Davis; 2012 May 5.
  2. Debuse D, Brace H. Outcome Measures of Activity for Children with Cerebral Palsy: A Systematic Review. Pediatr Phys Ther. 2011 Fall;23(3):221-31