While it's important for a physical therapist to have good verbal communication with a patient, it's essential not to rely too heavily on verbal cues from patients when determining their actual level of progress. It's not uncommon for patients to over or underestimate their progress, depending upon whether they want to minimize their pain and discomfort, or whether they are actually able to do more, but are afraid to do so out of fear of risking further injury or for other reasons.
This is why it's important for physical therapists to use objective measurements. Outcome tests can help them determine if patients are making real progress, or if they need to use a different approach in order for a patient to experience additional gains in function.
When to Use Measurement Tools?
At a minimum, a physical therapist should employ objective measurements at the following points of treatment.
- At the start of treatment.
- Midway through a treatment plan.
- When treatment is over.
The justification for this is as follows:
The Starting Point—In order to determine how much progress a patient is making, it's important to establish a baseline from which to measure progress.
Midway—Using measuring tools midway through a treatment plan helps therapists determine if their treatment is actually helping the patient, or if they need to revise their strategy in order to see improvement. Measurements taken midway can also provide a means of motivation for the patient when they learn all their hard work and effort is making a real difference in their recovery. Some insurances may also require that patients show measurable improvement in order to justify further treatment.
Post-Treatment—Measuring progress at the end of treatment informs a physical therapist of several things. It reveals whether a patient is
- Fully recovered and requires no additional treatment.
- Partially recovered, but requires further treatment to fully regain function.
- Unable to recover function and can expect to live with limitations.
Common Physical Therapy Tests
Timed Up and Go Test—Of course, it's essential to determine how safely a patient can navigate on their own. The Timed Up and Go test measures a person's ability to maintain their balance while walking and estimates their potential risk for falling.
The timed test begins with the patient fully seated in a chair. The patient must attempt to rise from the chair, walk 3 meters (an assistance device is permitted), turn around, walk back to the chair and sit down. Success or failure of the test depends upon whether the patient could complete the test without assistance from any person, as well as how long it took for them to complete the test.
The Oswestry Low Back Pain Disability Questionnaire—Low back pain is one of the most common ailments a physical therapist will treat. The Oswestry questionnaire provides helpful feedback to establish a baseline of function for a patient, as well as a measurement of progress during treatment. The questionnaire encompasses multiple areas of evaluation including activities such as lifting, standing, sitting, and personal care.
Depending upon how the patient answers the questions, the physical therapist will be able to determine what actions are difficult or impossible for a patient to perform and which activities are easily mastered by the patient.
Tinetti Gait and Balance Assessment Tool—This measurement tool is another common tool to determine how well a patient's balance system is performing. It also provides additional information about their ability to walk or whether they have problems with their gait.
Six Minute Walk Test—This test measures a person's basic exercise endurance, as well as their functional fitness. The test is very simple. The patient simply walks at a comfortable pace for six minutes. An assistive device is allowed during the test. The measurement of the success or failure of the test is determined by how much distance the patient covers during the six minutes.
Functional Independence Measurement—The FIM test is a comprehensive test that assesses multiple areas pertaining to independence. These areas include
- Sphincter control.
- Mobility (tub and shower mobility, transfer from toilet to wheelchair, etc.)
- Personal care.
- Locomotion (ability to walk, use the stairs, etc.)
- Social cognition.
For more information about the physical therapy industry or to learn more about starting your own physical therapy private practice, contact FYZICAL today.