PTOtherJournal of neurologic physical therapy : JNPT2018

A Core Set of Outcome Measures for Adults With Neurologic Conditions Undergoing Rehabilitation: A CLINICAL PRACTICE GUIDELINE.

Jennifer L Moore, Kirsten Potter, Kathleen Blankshain and 3 others

PMID 29901487

WHAT IT FOUND

Track adults with neurologic conditions using a common set of balance, walking, transfer, and patient goal outcome measures, administered consistently at admission and discharge when goals and capacity exist.

Key findings

01The recommended core set includes the Berg Balance Scale, Functional Gait Assessment, Activities-specific Balance Confidence Scale, 10 meter Walk Test, 6 Minute Walk Test, 5 Times Sit-to-Stand, and a patient goal assessment.

02The core set should be administered under the same conditions at least twice, at admission and discharge, and between those periods when feasible.

03Clinicians should discuss outcome measure results with patients and decide together how those results should guide the plan of care.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The guideline focused on measures that track change over time, not on measures used to predict recovery or diagnose a condition. The review searched by measure names, so studies using different names for the same construct may have been missed. Some recommendations, especially for transfers, patient goals, and shared decision-making, were based on best practice or limited evidence rather than strong measurement studies. The core set was not tested as a complete package, so its real-world time burden and effect on patient outcomes are unknown. Most evidence came from central nervous system conditions, so clinicians should use caution when applying the measures to peripheral nervous system conditions. Administration protocols varied across studies, so local standardization is needed to reduce measurement error.

Declared interests

The guideline development group received funding from the APTA to support the guideline's development.

The easy way to misread this

Do not read the guideline as requiring every measure for every patient. The recommended core set is for patients who have goals and capacity to improve balance, walking, or transfers, and a measure should not be used if it is not relevant.

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