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James L. Farnsworth II, Todd Evans, Helen Binkley, and Minsoo Kang

The use of patient-reported outcome measures (PROMs) has been shown to increase adherence to rehabilitation and improve communication between patients and their clinician through measurement of important subjective outcomes, such as quality of life and other psychological, sociological, and

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James L. Farnsworth II, Todd Evans, Helen Binkley, and Minsoo Kang

Patient-reported outcome measures (PROMs) help clinicians evaluate patients’ perceptions of changes in their own health status. These tools are especially valuable for measuring attributes that cannot be directly measured, such as pain, or that are not pragmatic or feasible to measure (eg

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Mackenzie Holman, Madeline P. Casanova, and Russell T. Baker

. Black N . Patient reported outcome measures could help transform healthcare . BMJ . 2013 ; 346 : f167 . PubMed ID: 23358487 doi:10.1136/bmj.f167 23358487 10.1136/bmj.f167 2. Nelson EC , Eftimovska E , Lind C , Hager A , Wasson JH , Lindblad S . Patient reported outcome measures in

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Annie C. Jeffries, Lee Wallace, Aaron J. Coutts, Shaun J. McLaren, Alan McCall, and Franco M. Impellizzeri

provide the ability to measure constructs and dimensions that are not objectively measurable. Patient-reported outcome measures are commonly used in clinical research and belong to the research field termed clinimetrics. Accordingly, international guidelines and initiatives have been established for the

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Luke M. Mueller, Ben A. Bloomer, and Chris J. Durall

Clinical Scenario:

Anterior cruciate ligament (ACL) injuries are associated with a lengthy recovery time, decreased performance, and an increased rate of reinjury. To improve performance of the injured knee, affected athletes often undergo surgical reconstruction and rehabilitation. Determining when an athlete is ready to safely return to play (RTP), however, can be challenging for clinicians. Although various outcome measures have been recommended, their ability to predict a safe RTP is questionable.

Focused Clinical Question:

Which outcome measures should be used to determine readiness to return to play after ACL reconstruction?

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Lori A. Michener

Outcome measures can be classified as clinician rated and patient rated. Clinician-rated measures predominantly assess impairments, whereas patient-rated measures, also known as patient-based measures, are designed to evaluate the impact of the injury on a patient’s daily activities, work, and recreation. Currently, there is a greater reliance on clinician-rated impairment measures for clinical decision making, specifically with treatment planning and assessing outcomes of care. To comprehensively evaluate the effect of an injury, patient-rated outcome measures must be used because they allow for the assessment of a patient’s ability to perform daily activities and participate in work and recreation that is affected by an injury. Clinician-rated impairment measures should be used to guide the development of a treatment program, and patient-rated measures should be used for both treatment-program development and assessing treatment outcomes in daily clinical practice. The purposes of this article are to describe patient- and clinician-rated outcome measures and to provide guidance and illustrate the benefits of the use of these measures in clinical decision making and documenting outcomes of care.

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Patti Syvertson, Emily Dietz, Monica Matocha, Janet McMurray, Russell Baker, Alan Nasypany, Don Reordan, and Michael Paddack

Context:

Achilles tendinopathy is relatively common in both the general and athletic populations. The current gold standard for the treatment of Achilles tendinopathy is eccentric exercise, which can be painful and time consuming. While there is limited research on indirect treatment approaches, it has been proposed that tendinopathy patients do respond to indirect approaches in fewer treatments without provoking pain.

Objective:

To determine the effectiveness of using a treatment-based-classification (TBC) algorithm as a strategy for classifying and treating patients diagnosed with Achilles tendinopathy.

Participants:

11 subjects (mean age 28.0 ±15.37 y) diagnosed with Achilles tendinopathy.

Design:

Case series.

Setting:

Participants were evaluated, diagnosed, and treated at multiple clinics.

Main Outcome Measures:

Numeric Rating Scale (NRS), Disablement in the Physically Active Scale (DPA Scale), Victorian Institute of Sport Assessment–Achilles (VISA-A), Global Rating of Change (GRC), and Nirschl Phase Rating Scale were recorded to establish baseline scores and evaluate participant progress.

Results:

A repeated-measures ANOVA was conducted to analyze NRS scores from initial exam to discharge and at 1-mo follow-up. Paired t tests were analyzed to determine the effectiveness of using a TBC algorithm from initial exam to discharge on the DPA Scale and VISA-A. Descriptive statistics were evaluated to determine outcomes as reported on the GRC.

Conclusion:

The results of this case series provide evidence that using a TBC algorithm can improve function while decreasing pain and disability in Achilles tendinopathy participants.

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Ashley N. Marshall and Jennifer S. Howard

and patient) and the continuity of care (communication between AT and other clinicians). Patient-Reported Outcome Measures Patient-reported outcome measures (PROMs) are questionnaires that are used to obtain patient-oriented evidence that matters, most often in relation to a particular injury

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Kelly M. Cheever, W. Geoffrey Wright, Jane McDevitt, Michael Sitler, and Ryan T. Tierney

/Ocular-Motor Screening) that could be assessed as part of a preseason baseline examination to predict future musculoskeletal injury risk have had limited success. 35 , 36 The lack of correlation between a clinically observable outcome measure(s) and musculoskeletal injury inhibits the creation of effective preventative

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Ellen C. Jørstad-Stein, Klaus Hauer, Clemens Becker, Marc Bonnefoy, Rachel A. Nakash, Dawn A. Skelton, and Sarah E. Lamb

The purpose of the study was to identify physical activity questionnaires for older adults that might be suitable outcome measures in clinical trials of fall-injury-prevention intervention and to undertake a systematic quality assessment of their measurement properties. PubMed, CINAHL, and PsycINFO were systematically searched to identify measurements and articles reporting the methodological quality of relevant measures. Quality extraction relating to content, population, reliability, validity, responsiveness, acceptability, practicality, and feasibility was undertaken. Twelve outcome measures met the inclusion criteria. There is limited evidence about the measures’ properties. None of the measures is entirely satisfactory for use in a large-scale trial at present. There is a need to develop suitable measures. The Stanford 7-day Physical Activity Recall Questionnaire and the Community Health Activities Model Program for Seniors questionnaire might be appropriate for further development. The results have implications for the designs of large-scale trials investigating many different geriatric syndromes.