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)
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
Copyright 2005 by the American Physical Therapy Association.
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 (firstname.lastname@example.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.
This article was submitted July 8, 2004, and was accepted January 28, 2005.
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.