Principles of Assessment and Outcome Measurement for Physical Therapists ksu. edu. sa Dr. taher _ yahoo. com Mohammed TA, Omar, Ph.D. PT Associate Proof Rehabilitation Science,

Course Objectives The purposes of this course is to enable qualified physiotherapists:  To understand the complex art and science of assessment processes  To be familiar with psychometric terms and to be able to identify the properties of tests  To select and confidently implement the use of appropriate standardized tests and outcome measures in their clinical practice and research related to neurological conditions.

Lecture Outline Physical Therapy and Geriatric Labels Used for Providers and Recipients of Therapy Services Therapists, Patients, Geriatric, Elderly, Importance of the Selection & Application of Terminology in Practice Assessment Evaluation Scale; Comparative and Non-comparative scale Tests Outcome Measurements Outcome Measurements

Patient-Therapy Relationship The word patient stems from the Latin word pati, which means ‘to suffer’ and is still used in medical settings, such as in- patient hospital care (Turner, 2002, p. 355). Throughout this course, the term therapist will be used to include physiotherapists. A clinician is defined as a ‘professionally qualified staff providing clinical care to patients’ (p. 30).

Physical Therapy in Geriatric Geriatric physical therapy covers numerous issues concerning people as they go through normal adult aging. These include (but are not limited to) arthritis, osteoporosis, cancer, Alzheimer's disease, hip and joint replacement, balance disorders and incontinence. arthritisosteoporosiscancerAlzheimer's diseasehip and joint replacementbalance disordersincontinence Geriatric physical therapists develop individualized programs to help restore mobility, reduce pain and increase fitness.

Assessment Assessment is the overall process of selecting and using multiple data-collection tools and various sources of information to inform decisions required for guiding therapeutic intervention during the whole therapy process. Assessment involves interpreting information collected to make clinical decisions related to the needs of the person and the appropriateness and nature of their therapy. Assessment is a process that encompasses the evaluation and measurement of outcomes

Evaluation Evaluation is a component of a broader assessment process. It involves the collection of data to enable the therapist to make a judgment about the amount of a specific construct of interest (such as degree of range of movement or level of independence in an activity of daily living) or to make a judgment about the value of an intervention for delivering the desired outcome for a person or the value of a service for delivering outcomes of relevance to the client population. Evaluation often involves data being collected at two time points in order to measure effect and also can involve the translation of observations to numerical scores.

Evaluation Physical Therapist Patient/Client Management Model—Evaluation.

scale Within therapy and rehabilitation literature, we use the terms scale, rating scales and measurement scales. A scale provides a means of recording something that can be rated in terms of levels, amounts or degrees. Therapists use scales to rate the presence or severity of a problem, such as a symptom, or to rate the person’s level of independence in a needed or chosen occupation, activity or task. Scales can be categorized into one of four levels of measurement: nominal, ordinal, interval or ratio. Numbers are frequently assigned as scores in scales and its use and interpretation depends upon the level of measurement used in the scale.

TEST A standardized type of examination; given to a group or individual; it may be qualitative or quantitative, to determine presence or absence of a particular capacity, knowledge or skill, or determine the degree in which such is present; in the latter case, the degree may be determined by the relative position of an individual in the group or whole population, or by assigning a definite numerical value in terms of some selected unit.

TEST Test (exam) is a procedure or set of procedure that is used to obtain measurements (data); that may require the use of instruments. Instrument is ‘a device for recording or measuring’ Comparative and Non-comparative scale

MEASUREMENT A measurement is the data obtained by measuring. Measuring is undertaken by therapists to ascertain the dimensions (size), quantity (amount) or capacity of a trait, attribute or characteristic of a person that is required by the therapist to develop an accurate picture of the person’s needs and problems to form a baseline for therapeutic intervention and/or to provide a measure of outcome. A measurement is obtained by applying a standard scale to variables, thus translating direct observations or client/proxy reports to a numerical scoring system.

Objective MEASUREMENT Objective Measurement: a measurement that is not affected by some aspect of person obtaining the measurement. The term objective relates to the reliability of measurements, especially the inter-tester reliability. What is the subjective measurement?

MEASUREMENT Measuring is undertaken by therapists; To make diagnosis To describe status (baseline for therapeutic intervention) To document change (worth or improvement). To explain performance. To predict outcome measure. Measurement is obtained by applying a standard scale to translate direct observations or client/proxy reports to a numerical scoring system.

OUTCOME Outcome: refer to the effects of treatment, programs or policies on individuals or populations. Outcomes may also be defined as changes in status attributed to a specific intervention or treatment. For physical therapists, outcomes may be thought of as changes in the lives of clients and their environment (s) as a result of rehabilitation.

Outcome Secondary Outcome can be supportive measurements of the primary objective or measurements of effects related to other secondary objectives. OUTCOME Primary Outcome represents the variable providing the most relevant and convincing evidence related to the main objective of the research.

OUTCOME Measurement An outcome measure is a standardized instrument, tools, equipment, and scales used by therapists to establish whether their desired therapeutic outcomes have been achieved  An outcome measurement is a process undertaken to establish the effects of an intervention on an individual or the effectiveness of a service on a defined aspect of the health or well-being of a specified population.

OUTCOME Measurement Outcome measurement is achieved by administering an outcome measure on at least two occasions to document change over time in one or more trait, attribute or characteristic to establish whether that trait/attribute/characteristic has been influenced by the intervention to the anticipated degree to achieve the desired outcome.

Sensitive to changes in a person’s problems Established reliability and validity Scoring (e.g. hand, computer) Ease of administration (self-report) Relevance to the goals of treatment Selecting Outcome Measurement Norms

Relationship between Variables Tests are specific instruments used to collected data and administrating a test is a process of measurement, without test, measurements would be impossible. Measurement is a technique necessary for evaluation Evaluation is a broader term representing a more complex process than the other two.

Relationship between Variables

Self Test Q2: Define test, measurement, evaluation and assessment ? Q3: What is the interrelationships among test, measurement, evaluation and assessment? Q4: Identify the purposes of measurements?