Discover a range of physical therapy assessment tools including balance, functional & outcome assessments. Explore standardized assessments used by PTs.
Physical therapy assessment tools and functional outcome measures are the building blocks of evaluating a patient's condition and tracking their improvements throughout the course of their treatment. Physical therapists must leverage these tools daily to comprehensively assess and benchmark a patient's range of motion, strength, and overall physical function. With a benchmark in place, PTs can create personalized treatment plans and quantify progress over time.
This article will discuss commonly used physical therapy assessment tools and how they can support your evidence-based therapy and motivate patients to continue their treatment.
Functional assessment tools in physical therapy give you a baseline level of function against which you measure your patient's improvement over time. Comparing later assessments to the baseline shows patient improvement with the existing treatment plan or a need to reevaluate treatment. Using these tools is among the best practices for physical therapy today.
Functional outcome measures quantify a patient's function improvement throughout an episode of care. Physical therapy outcome measures allow therapists to create a definitive baseline of patient ability and compare advancements in function in real-time. They enable providers to document the effectiveness of treatment and improve care where necessary. As the Centers for Medicare & Medicaid Services (CMS) pushes for evidence-based practice (EBP), functional outcome measures provide a credible and reliable patient treatment rationale. At the practice level, therapists can leverage functional outcome measurements in physical therapy to demonstrate valid progress data that indicates a high quality of care. Best practices to document and promote physical therapy outcome measures include:
Outcome measurement tools are a method to track a patient's current functional status at the time of intake, throughout an episode of care, and at the time of discharge. Physical therapy outcome measures corroborate a patient's self-report and the physician-indicated impairments of body structure, function, and activity limitations on an individual's SOAP note. Over time, outcome measurement tools can aggregate patient data to compare treatment results and the number of sessions in an average episode of care for a particular ailment or condition. These tools can then be used to compose a patient plan of care, estimate the amount of time it will take for functional improvement, and analyze the potential risks of treatment.
Outcome assessment tools are pivotal in a successful — and profitable — physical therapy practice. Physical therapy assessment tools allow providers to quantify patient improvement over time reliably. With a baseline of patient mobility, range of motion, and strength at intake, providers can track actionable changes in patient function throughout care to report to payers. Likewise, physical therapy measurement tools can be used to compare a patient's current improvement timeline to similar patients of the same age, weight, and condition. If a patient does not similarly respond to treatment, providers can re-evaluate the patient to determine a more effective care plan. In this way, providers, patients, and payers receive evidence-based care.
Moreover, outcome assessment tools allow patients to remain engaged with their care. Such tools enable patients to observe improvements in their function throughout treatment, from intake to discharge, to inspire them to actively contribute to their care plan. Providers can also use patient improvement and engagement as the basis of local marketing campaigns.
At the start of an episode of care, a physical therapist will administer various physical therapy outcome assessment tools to create a baseline of a patient's current functional abilities. Outcome measurement tools quantify the functional improvement over time as the patient progresses through treatment. Common physical therapy measurement tools include:
NDI is a self-reported 1-6 leveled questionnaire that quantifies how severe neck pain impacts functional mobility and daily living activities, such as vehicle operating, personal care, and professional activity.
The NDI works best with patients with acute or chronic pain caused by musculoskeletal problems, thoracic disc syndrome, cervical radiculopathy, or whiplash. For instance, a patient who had whiplash from a car accident may need the NDI to see if PT improves their pain and functioning. Patients should have an NDI score decrease by at least five points to show improvement from their PT treatment plan.
Tinetti Balance Assessment Tool is a therapist-administered lower body stability and balance test to assess the various gait and balance factors, including step length, path deviation, walking stance, and trunk sway.
Patients with injuries in the lower extremities, neurological conditions that affect muscle tone and balance, or sensory loss may need this functional outcome measurement tool to determine how their balance is affected. Elderly patients with aging-related weakness or those who have neurological problems that impact walking, standing, and sitting balance are among those who typically have this functional outcome measurement used as a baseline. This test is among the most commonly used assessment tools for older people in physical therapy to identify fall risk.
Quick DASH is a self-reported outcome measurement tool used to quantify physical function in patients with shoulder, arm, and hand musculoskeletal disorders by scoring disability symptoms and optional high-performance sport or work modules.
The Quick DASH functional assessment tool allows physical therapists to examine patients with arm, hand, or shoulder pain. The tool creates a baseline against which future tests show patient improvement or a need for a new treatment plan. For instance, a patient recovering from shoulder surgery may have this assessment to see how much their quality of life improves while receiving physical therapy services.
Functional Reach Test is a therapist-administered mobility and balance test that has patients place both arms at a 90° flexion to assess the difference, in centimeters, between arm's length and a max forward reach.
The Functional Reach Test is another example of physical therapy's many balance assessment tools. PTs use this with patients who may need to determine their fall risk and mitigate it through physical therapy. Patients who experienced an injury or illness that affected their balance and mobility may need this assessment. With the Tinetti Balance Assessment and Berg Balance Scale, the Functional Reach Test offers another way to measure balance capability and fall risk for elderly patients.
LEFS is a self-reported 0-4 leveled questionnaire that uses 20 questions to assess the ability to perform everyday tasks, like squatting, walking a mile, and running on uneven ground, in patients with disorders of the lower extremities.
Adults who report lower extremity problems undergo this assessment to identify their level of disability at varying points throughout their treatment. Patients who improve from PT have a change in their LEFS score of at least nine points. Often physical therapists use this assessment to ensure that athletes progress as expected to return to their sport after an injury or surgery.
The Berg Balance Scale is one of the fall assessment tools used in physical therapy, especially for elderly patients. This test uses a 14-question assessment with each response on a scale from 0-4. The results of this scale determine balance while sitting, standing, and rising among those who have decreased stability in the lower body and balance issues. It does not test balance while walking, which is this assessment's major limitation.
Patients with balance concerns that may have a fall risk from weakened lower limbs may undergo this assessment to track improvement in balance. To show positive patient outcomes, patients should score increases of four to seven points on this scale. Patients with multiple sclerosis, spinal stenosis, peripheral neuropathy, or other sources of weakness in the lower extremities may require this functional outcome assessment.
The intensive Fugl-Meyer Assessment (FMA) has 155 items covering five areas: joint pain, balance, sensory functioning, motor functioning, and joint range of motion. It determines condition severity and functioning after a stroke.
Among the standardized assessment tools for physical therapy, this test is the only one used exclusively to assess patients with hemiplegia after a stroke. The test monitors the effectiveness of rehabilitation after the stroke by monitoring whether the level of disability the patient experiences decreases per the assessment results. The overall test assesses improvements in motor skills, as the total of this measure does not include the functional aspects of the test.
The Oswestry Disability Index (OSI) has over 20 years of use and 200 scientific citations supporting its effectiveness. It remains the "gold standard" for back pain assessment. The ODI tool asks about the difficulty patients experience when doing ten everyday daily activities. Each of the ten items has six responses based on the perceived impact on the quality of life the patient experiences for each. Higher scores correlate to more significant disability and an enhanced need for intervention.
Physical therapists trust the ODI to assess the baseline and improvement of their patients with low back pain. ODI requests patients to answer the impact of their back pain on their lives before, during, and after PT. This outcome measure works best with patients with chronic or acute low back pain that causes lasting, severe disabilities in their lives.
Once the above functional outcomes measures have been administered, the resulting data is often input into outcome assessment tools, such as MWTherapy Physical Therapy Outcomes Software. Such software assessment tools allow PT professionals to measure the impact of treatment over time and help continuously improve the overall quality of care and patient success. Likewise, suppose a physical therapy practice participates in quality programs like the Merit-Based Incentive Payment System (MIPS). In that case, using physical therapy outcomes software helps more effectively collect and manage patient quality data for simple and easy reference. This data supports continuous, high-quality care with more emphasis on evidence-based care than ever.
Functional testing in physical therapy is more than just setting a baseline for patient illness or injury — it's a method to reliably quantify the effectiveness of treatment, gauge patient improvement over time, and engage patients in their care. Functional outcome measures provide valuable data for informed patient care and impactful practice marketing.
If you need help figuring out where to start with functional testing in physical therapy, MWTherapy and our extensive EMR product suite are here to help. With features to document functional outcome measures, aggregate data over time, and leverage insights for promotional materials, now is the time to start functional testing. Schedule a demo today to learn more.
