Keeping it all in balance: a qualitative analysis of the role of balance outcome measurement in physical therapist decision-making and patient outcomes

Abstract

Purpose

The use of outcome measures (OMs) is a hallmark of contemporary physical therapy in the USA. The effect of OM utilization on patient care decisions and the results of PT services remain poorly understood. The purpose of this study is to explore PTs perceptions about the relationship between balance OMs and decision-making and how that interaction impacts patient outcomes, particularly for patients with acquired brain injury.

Materials and methods

This qualitative study used semi-structured phone interviews with an interview guide. Maximum variation sampling was used. Thematic analysis was situated in a priori determined theory-based categories.

Results

Twenty-three physical therapists (PTs) from diverse geographic areas and practice settings participated. Therapists expressed diverse views on the impact of OM use on patient outcomes, but the majority perceived that using OMs improved rehabilitation outcomes. The use of OMs was related to the selection of optimal intervention type and intensity and justified continued high-frequency rehabilitation services. OMs were important to therapists’ decision-making.

Conclusions

In the present study, PTs reported that they believe the use of validated, clinically useful OMs may improve patient outcomes.

Implications For Rehabilitation

• Balance outcome measures are considered an important tool to the optimal management of the profound impact of balance impairments after brain injury.

• Most physical therapists in this study believe that using balance outcome measures results in better outcomes for patients with brain injury.

• In this study, physical therapists reported using outcome measures in wide-ranging ways to guide clinical decisions about balance in those with brain injury.

Keywords:

• Balance
• outcome measures
• qualitative
• decision-making
• clinical reasoning
• brain injury

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Texas Physical Therapy Foundation Grant. Gratitude is extended to Dr. Rachel MacNeill, who served as a research assistant for this work.