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The Centers for Medicare and Medicaid Services encourages clinicians
to use OPTIMAL to document that a patient qualifies for an automatic
exception to the outpatient therapy cap.
Find out how to obtain permission to use
OPTIMAL.
Physical Therapy
· Volume 85 · Number 6 · June 2005 · pp.
515-530
Development and Testing of a Self-report Instrument to Measure
Actions: Outpatient Physical Therapy Improvement in Movement Assessment
Log (OPTIMAL)
ABSTRACT
Andrew A Guccione, Thelma J Mielenz, Robert F DeVellis, Marc S
Goldstein, Janet K Freburger, Ricardo Pietrobon, Sarah C Miller, Leigh F
Callahan, Kenneth Harwood, and Timothy S Carey
Background and Purpose
Physical therapy is faced with the challenge of producing evidence
that physical therapy interventions are effective. The fundamental
question confronting physical therapy is whether or not physical therapy
interventions make a contribution to function, health, and well-being.
The individual's ability to perform actions can serve as a theoretical
construct related to movement and health around which physical therapy
interventions can be assessed. To this end, the aims of this study were:
(1) to develop a self-report instrument to assess ability to perform
mobility actions in an adult outpatient population and (2) to assess the
psychometric properties of such an instrument in the appropriate
population. Subjects and Methods. An instrument was developed to assess
difficulty and confidence related to 24 actions. Descriptive statistics
and measures of reliability, validity, and responsiveness were computed.
A total of 391 patients participated in the study. Results. The
coefficient for reliability was in the required range, and measures of
validity and responsiveness were established as well. Three factors were
identified. Discussion and Conclusion. The instrument provides the
beginning of documentation of outcomes in movement to identify the
unique contributions of physical therapist practice. [Guccione AA,
Mielenz TJ, DeVellis RF, et al. Development and testing of a self-report
instrument to measure actions: Outpatient Physical Therapy Improvement
in Movement Assessment Log (OPTIMAL). Phys Ther. 2005;85:515-530.]
Key Words: Actions, Movement, Outcomes, Physical
therapy, Reliability, Responsiveness, Validity
Click here for full-text article
Copyright 2005 by the American Physical Therapy
Association.
Author Information
AA Guccione, PT, DPT, PhD, FAPTA, is Senior Vice President, Practice
and Research Division, American Physical Therapy Association, 1111 N
Fairfax St, Alexandria, VA 22314-1488 (USA).
TJ Mielenz, PT, PhD, OCS, is Research Faculty, Thurston Arthritis
Research Center, and Assistant Professor, Division of Physical Therapy,
School of Medicine, University of North Carolina at Chapel Hill, Chapel
Hill, NC.
RF DeVellis, PhD, is Research Professor, Department of Health
Behavior & Health Education, School of Public Health, and Adjunct
Professor, Department of Psychology, College of Arts and Sciences,
University of North Carolina at Chapel Hill.
MS Goldstein, EdD, is Director of Research Services, Practice and
Research Division, American Physical Therapy Association (marcgoldstein@apta.org).
Address all correspondence to Dr Goldstein.
JK Freburger, PT, PhD, is Research Associate and Fellow, Cecil G
Sheps Center for Health Services Research, and Assistant Professor,
Division of Physical Therapy, School of Medicine, University of North
Carolina at Chapel Hill.
R Pietrobon, MD, PhD, is Assistant Research Professor, Center for
Excellence in Surgical Outcomes, Duke University Medical Center, Durham,
NC.
SC Miller is Assistant Director of Research Services, Practice and
Research Division, American Physical Therapy Association.
LF Callahan, PhD, is Associate Professor, Departments of Medicine,
Orthopaedics and Social Medicine, School of Medicine; Adjunct Associate
Professor, Department of Epidemiology, School of Public Health; and
Research Fellow, Cecil G Sheps Center for Health Services Research,
University of North Carolina at Chapel Hill.
K Harwood, PT, PhD, CIE, is Director of Practice, Practice and
Research Division, American Physical Therapy Association.
TS Carey, MD, MPH, is Director of the Cecil G Sheps
Center for Health Services Research; Professor, Internal Medicine and
Social Medicine, School of Medicine; and Adjunct Professor, Department
of Epidemiology, School of Public Health, University of North Carolina
at Chapel Hill.
Dr Guccione, Dr Mielenz, Dr DeVellis, Dr Goldstein,
Dr Freburger, Dr Callahan, and Dr Carey provided concept/idea/research
design. Dr Guccione, Dr Mielenz, Dr Goldstein, Dr Freburger, and Dr
Harwood provided writing. Dr Guccione, Dr Goldstein, and Ms Miller
provided data collection, and Dr Mielenz, Dr DeVellis, and Dr Pietrobon
provided data analysis. Dr Guccione, Dr Mielenz, Dr Goldstein, Dr
Freburger, and Ms Miller provided project management. Dr Mielenz and Dr
Freburger provided fund procurement. Dr Mielenz, Dr Goldstein, and Dr
Freburger provided institutional liaisons. Dr Mielenz provided clerical
support. Dr Mielenz, Dr DeVellis, Dr Freburger, Dr Pietrobon, Dr
Callahan, Dr Harwood, and Dr Carey provided consultation (including
review of manuscript before submission). The authors acknowledge
Laurence N Benz, PT, DPT, ECS, OCS; Janet R Bezner, PT, PhD; William
Boissonnault, PT, DHSc, FAAOMPT; Anthony Delitto, PT, PhD, FAPTA;
Christopher Hughes, PT, PhD, OCS; Sue Palsbo, PhD; Carol Q Porter, BS;
Mara Wernick Robinson, PT, MS, NCS; Carol Schunk, PT, PsyD; Richard K
Shields, PT, PhD; Michael G Sullivan, PT, DPT, MBA; Karen Thornton, PT,
MS, PCS; and especially the physical therapists and staff at Kentucky
Orthopedic Rehab Team, Massachusetts General Hospital, MONARC Therapy
Center at Benefis Healthcare, and National Rehabilitation Hospital for
their contributions to and participation in this study.
Article
Information
This article was submitted July 8, 2004,
and was accepted January 28, 2005.
Permissions Information
While APTA intends to permit use of OPTIMAL at no
charge to 1) clinicians within their facilities for patient care, 2)
bona fide education institutions using material for in-classroom use,
and 3) entities conducting research, it is the copyrighted intellectual
property of Physical Therapy (PTJ) and so permission is required.
Entities wishing to use OPTIMAL in commercial products or services,
including other publications, also must apply for permission;
products/services other than publications potentially will be required
to enter into a licensing agreement with APTA for such use.
Clinician requests must specify that OPTIMAL is to be used for patient
care within the facility at no charge.
Other requests must include title or type of
publication/product in which OPTIMAL will appear, estimated size and
demographic of audience, or print quantity of publication, and scope of
permission.
Written requests may be submitted via mail, fax, or
e-mail to the following: Michele Tillson, APTA Publications Department,
1111 N Fairfax St, Alexandria, VA 22314; Phone: 703/706-3194; Fax:
703/706-3169; E-mail: micheletillson@apta.org.
[Last updated: 02/15/08 | Contact: research@apta.org]
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