Evaluating rehabilitation outcomes from the client's perspective by identifying the gap between current and preferred movement ability

Abstract

Purpose. Examine the theoretical construct of a gap between people's perceived current and preferred movement abilities and its potential for evaluating rehabilitation outcomes against clients' desired goals.

Method. A cross-section of 311 community-dwelling adults completed a 24-item movement ability measure (MAM) and a visual analog movement scale. In a nonrandomized pre–post design, two subsets of that population completed the measures again after 2 weeks: 35 clients undergoing outpatient physical therapy and 34 in a comparison group who were not undergoing physical therapy. Scores on the MAM were analyzed using item response theory methods.

Results. The gap between current and preferred ability in the 311 adults represented one level difference on average out of six designated movement levels on both measures. Clients about to undergo physical therapy had gaps approximately twice the size of gaps in the 34-person comparison group on both measures (P < 0.001). Both the MAM and the movement scale showed a significantly narrower gap after 2 weeks for the group in physical therapy (P < 0.001) but no change for the comparison group.

Conclusions. Assessing gaps between client-perceived current and preferred movement ability following intervention may help in the evaluation of rehabilitation outcomes from the client's perspective.

Keywords:

• Patient outcome assessment
• patient preference
• movement

Acknowledgments

Dr. Allen acknowledges the support of a post-doctoral fellowship from the National Institute on Disability and Rehabilitation Research (NIDRR), grant #H133P0001, at the Health and Disability Research Institute, School of Public Health, Boston University, Boston, MA.