The use of outcome measures has become the standard of care to objectively assess changes in function, quantify clinical observations, enhance interdisciplinary communication, and examine intervention effectiveness at the patient and practice levels. Inconsistent use of outcome measures remains an issue due to difficulty identifying the most suitable measures based on patient diagnosis, acuity of condition, or practice setting.

A recently published clinical practice guideline (CPG) aimed to identify a core set of outcome measures that can be used for all adults with neurological conditions across the continuum of care. The CPG offered nine action statements specific to balance, gait and transfers, documentation of patient goals, and the use of a patient/provider collaborative approach discussing outcome measure results. The majority of these action statements are supported by level I evidence and strong recommendations. The CPG outcome measures are free to use, require equipment commonly available in a clinic, and take 20 minutes or less to implement. It was developed with the support of the American Physical Therapy Association (APTA) and the Academy of Neurologic Physical Therapy (ANPT).¹

Action statements in the Neurologic CPG¹ and across other appropriate populations²

Additional factors to consider when scoring these Outcome Measures²

• If a patient cannot perform one or more of the outcome measures and it is reasonable for them to have a related goal, a score of 0 should be documented. This provides an objective baseline for comparison.
• If touching assistance or a gait belt is held during the balance component of the BBS, the lowest appropriate score should be used.
• If an assistive device is used to walk during the FGA, the same assistive device should be used when the test is repeated. If the use of an assistive device is not specified in the scoring and an assistive device is used, the score is 0.

References:
1. Moore JL, Potter K, Blankshain K, Kaplan SL, O’Dwyer LC, Sullivan JE. A Core Set of Outcome Measures for Adults With Neurologic Conditions Undergoing Rehabilitation: A Clinical Practice Guideline. Physical Therapy. 42:174-220, 2018
2. Sullivan JE. How the Neuro Outcomes Clinical Practice Guideline Informs Standardized Reporting and Best Care Practices in Physical Therapy. Illinois Physical Therapy Association. June 6, 2019