Development of a framework for the evidence-based choice of outcome measures in neurological physiotherapy.
BACKGROUND
Neurological physiotherapists recognize the need to include standardized outcome measures (OMs) in clinical practice but lack of information about the OMs available hampers utilization. This paper reports on the first stage of a project to identify the most robust OMs for use in neurological physiotherapy.


OBJECTIVE
To identify what physiotherapists perceive that they need to measure during a neurological assessment.


METHODS
Three separate workshops were held using patient vignettes to represent the acute, rehabilitation and community settings. Thirty senior neurological physiotherapists participated and were asked: 'What would you observe, test or measure if assessing this patient?' Data were analysed using thematic content analysis performed independently by each of the authors. Internal and external member checking ensured validity. In addition, the authors produced definitions of the items and domains identified in the data collection and subsequent content analysis.


RESULTS
Items from the data collection were classified into 16 domains that physiotherapists need to measure: Weakness; range of movement/contracture; pain; muscle tone/spasticity; sensation; ataxia/co-ordination; personal fatigue; oedema; subluxation; postural and balance impairment; walking impairment; upper limb; balance disability; walking disability; mobility disability and falls.


CONCLUSIONS
The domains that physiotherapists need to measure during clinical assessment were identified. In the second stage of the project these domains will inform systematic reviews to identify the most robust outcome measures for use in clinical practice.
Tyson
Sarah
S
Physiotherapy Directorate, University of Salford, UK. s.tyson@salford.ac.uk
Watson
Anita
A
Moss
Sylvia
S
Troop
Hilary
H
Dean-Lofthouse
Gill
G
Jorritsma
Sjoerd
S
Shannon
Michelle
M
D019317:Evidence-Based Medicine; D017144:Focus Groups; D006801:Humans; D009422:Nervous System Diseases / Q000145:classification / Q000503:physiopathology / Q000534:rehabilitation*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D026761:Physical Therapy Specialty / Q000379:methods / Q000458:organization & administration*; D006113:United Kingdom