A Core Set of Outcome Measures to Assess Physical Function for Adults Participating in Physical Therapist Treatment in the Hospital: A Clinical Practice Guideline

Abstract

Importance: Outcome measures (OMs) are an integral part of physical therapist practice and implementation can have a multifaceted effect on care delivery.

Objective: The objective of this project was to identify a core set of OMs for adults requiring acute care hospitalization in the setting of acute care physical therapist practice.

Design and setting: This Clinical Practice Guideline (CPG) focuses on the assessment of physical function within the "activity" domain of the International Classification of Functioning, Disability and Health.

Main outcomes and measures: The CPG scope was developed with input from interested parties at multiple levels, including Academy of Acute Care Physical Therapy leadership, the CPG Working Group, and consumers of acute care physical therapist practice. A systematic review assessed psychometric data on physical function OMs that included the constructs of bed mobility, transfer ability, and ambulation. The modified Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN-M) was used to examine methodological quality and psychometric strength for each OM. Recommended OMs in the core set met 3 criteria: addressed the established constructs, had strong psychometric properties and methodological quality, and had high clinical utility, defined as minimal time (<20 minutes), low to no cost, and minimal training required for use in clinical practice.

Results: Thirty-four OMs were initially identified in the systematic review. Fourteen OMs were considered for the final CPG. In the end, action statements 1 to 3 supported 3 OMs that comprised the acute care core outcome measure set (COMS), and action statements 4 to 8 were recommendations for supplemental OMs that may be performed as additions to augment the COMS. All action statements considered the published evidence, clinical utility, and acute care expertise from the Guideline Development Group. Research recommendations follow each summary of the evidence.

Conclusions and relevance: The CPG provides recommendations for COMS to assess physical function in acute care physical therapist practice.

Keywords: Activity Limitations; Acute Care Physical Therapy; Core Outcome Measures Set; Evaluation; Physical Function; Standardized Outcome Measures.