Development and Testing of a Self-report Instrument to Measure Actions: Outpatient Physical Therapy Improvement in Movement Assessment Log (OPTIMAL)

Abstract

Background and Purpose. Physical therapy is faced with the challenge of producing evidence that physical therapy interventions are effective. The fundamental question confronting physical therapy is whether or not physical therapy interventions make a contribution to function, health, and well-being. The individual's ability to perform actions can serve as a theoretical construct related to movement and health around which physical therapy interventions can be assessed. To this end, the aims of this study were: (1) to develop a self-report instrument to assess ability to perform mobility actions in an adult outpatient population and (2) to assess the psychometric properties of such an instrument in the appropriate population. Subjects and Methods. An instrument was developed to assess difficulty and confidence related to 24 actions. Descriptive statistics and measures of reliability, validity, and responsiveness were computed. A total of 391 patients participated in the study. Results. The coefficient for reliability was in the required range, and measures of validity and responsiveness were established as well. Three factors were identified. Discussion and Conclusion. The instrument provides the beginning of documentation of outcomes in movement to identify the unique contributions of physical therapist practice.

Validity, Reliability, and Responsiveness of the Spanish Version of the OPTIMAL Instrument

“…The Outpatient Physical Therapy Improvement in Movement Assessment Log (OPTIMAL) is a self‐report instrument developed to measure the ability to perform mobility actions in the adult physical therapy population . It consists of 2 scales, difficulty and confidence, that respectively assess difficulty and confidence in performing movements.…”

“…The original study of the OPTIMAL identified 3 factors in the 2 scales: trunk mobility, lower extremity mobility, and upper extremity mobility. Cronbach α coefficients were 0.85‐0.95 in these subscales . Each scale consists of 22 items related to the mobility domain within the activities and participation component of the International Classification of Functioning, Disability and Health .…”

“…Few health care measures permit such individualization, most notably the Patient‐Specific Functional Scale and the Patient‐Generated Index . Second, this instrument allows for the assessment of the ability to make movements from not only a physical perspective (difficulty) but also from an affective one (confidence) . The difficulty in performing actions is a concept that is included in many functional status questionnaires .…”

“…Patient‐reported outcome measures, more and more frequently used and valued in physical therapy and rehabilitation , include health aspects that cannot always be collected with objective measures . Indeed, the OPTIMAL instrument was developed with the intent of assessing patient movement ability according to the patient's perspective and environment .…”

“…The OPTIMAL instrument is available in English and Italian versions, with good psychometric properties. Given the growing implementation of international research projects and the need to consider immigrant populations in health care assistance services and populations from non–English‐speaking countries , the aim of this study was to obtain a Spanish‐adapted version of the OPTIMAL instrument with appropriate levels of reliability, validity, and responsiveness to measure the ability to perform mobility actions.…”