FUNCTIONAL OUTCOME MEASURES FOR A PRIVATE CLINIC

Why do we need them?

1. Establishing a benchmark 2. Tracking progress 3. Way to describe disability experienced by the patient 4. Outlines areas of difficulty that can be used as short term goals5. Demonstrating the benefit of physiotherapy 6. Legal issues

QUICK DASH – Disabilities of the Arm, Shoulder, and Hand

About 11 item questionnaire scored between 1-5– shorter version of the DASH that

measures physical function and symptoms in patients with any or several musculoskeletal injuries to the upper limb

o MSK includes bone, tendon, ligaments, muscle Goal is to describe the disability experienced by the patient and monitor changes in

symptoms and function over time Optional Modules goal is to determine any difficulties that may be experienced that

pertain to specific areas that may have been missed in the original 30 item portion o Sport/music o Work

Scoring At least 10/11 items must be completed in order to score and 4/4 on optional

modules All the scores are summed and averaged and then transformed into a score out of

100 where a higher score indicates greater disability

DASH disability/symptom score ¿ [( [ (∑ of nresponses )]n )−1] x 25

where n is equal to the number of completed responses. Online version which will score it for you if needed

-http://www.orthopaedicscore.com/scorepages/disabilities_of_arm_shoulder_hand_score_quickdash.html

Excel sheet that can be used to track scores either within a patient or between patients

LOWER EXTREMITY FUNCTION SCALE

About Self-report, 20-item questionnaire that measures patients initial function, ongoing

progress, and outcome for general lower extremity conditions Intended for use on adults with lower extremity conditions 0-4 with 0 representing extreme difficulty or unable to perform activity and 4

representing no difficulty

Scoring: Add up all the column totals at the bottom to get a final score out of 80 A higher score indicates high function and a lower score indicates low function

NECK DISABILITY INDEX

About 10 items questionnaire that includes the following categories: pain, personal care,

lifting, reading, headaches, concentration, work, driving, sleeping and recreation. Specifically for neck pain Intended population: chronic neck pain, musculoskeletal neck pain, whiplash

injuries (WAD), and cervical radiculopathy

Scoring Each item is ranked 0-5 and the total is added up for a total possible score of 50. 0-4points (0-8%) no disability,

5-14points (10 – 28%) mild disability, 15-24points (30-48% ) moderate disability, 25-34points (50- 64%) severe disability,35-50points (70-100%) complete disability

higher score indicates higher disability

BACK PAIN FUNCTIONAL SCALE

About self report, 12-item questionnaire to determine functional ability in people with

back pain intended population: people with back pain

Scoring each item is ranked 0-5 with 0 meaning unable to perform the activity and 5

meaning no difficulty with the activity total of 60- the higher the score the better functional ability the patient has

Recommendations Ask patients to arrive 15 min early before their 1stappointment in order to fill out

the appropriate outcome measure and then every 3 weeks including the last appointment

Use of the Excel DASH Scoring e-tool or other appropriate outcome measure should be completed to track individual patient progress and then printed off at the end of the 6-week treatment session to demonstrate progress

FUTURE: download the DASH app and have patients complete it directly on an ipad.

REFERENCES

Binkley JM, Stratford PW, Lott SA, Riddle DL. The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. North American Orthopaedic Rehabilitation Research Network. Phys Ther. 1999 Apr;79(4):371-83.

Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG) Am J Ind Med. 1996 Jun;29(6):602-8. Erratum in: Am J Ind Med 1996 Sep;30(3):372.The Institute for Work & Health are the copyright owners of the DASH and QuickDASH Outcome Measures

Vernon H.& Hagino,C, Neck Disability Index HVERNON@CMCC.CA, 1991

Stratford PW Binkley JM et al. Development and initial validation of the Back Pain Functional Scale. Spine. 2000; 25: 2095-2102