Psychometric Properties of the Outpatient Physical Therapy Improvement in Movement Assessment Log (OPTIMAL) in Patients With Musculoskeletal Disorders: A Replication Study With Additional Findings

Abstract

The findings generally did not support the psychometric properties of the OPTIMAL instrument. Although not conclusive, the data suggested that the OPTIMAL Difficulty and Confidence scales demonstrate substantial overlap. Reliability was generally low, with the exception of the lower-extremity subscale. Scores for the subscales of the Difficulty Scale differentiated among patients with lower-extremity versus trunk or upper-extremity diagnoses, but associations with previously validated region-specific measures were generally weak or absent. Clinicians treating outpatients with musculoskeletal disorders should consider alternative measures when attempting to quantify the extent of activity limitations.

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

“…In our analysis, we found significant differences ( P < .001) between the scores obtained from these 2 scales (by Wilcoxon signed‐rank test). The OPTIMAL confidence score showed higher values than the OPTIMAL difficulty score, as in studies carried out with the English version . The fact that the OPTIMAL confidence scale measured significantly higher levels of disability than the OPTIMAL difficulty scale offers evidence regarding content validity supporting the idea that they are measuring 2 distinct dimensions related to movement.…”

“…The OPTIMAL instrument measures the difficulty and confidence in performing movements. According to Riddle et al , the 2 scales overlap with each other, but according to Guccione and Mielenz , they are 2 different constructs related to movement and therefore should be scored separately. In our analysis, we found significant differences ( P < .001) between the scores obtained from these 2 scales (by Wilcoxon signed‐rank test).…”

“…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.…”

Capacidad de movimiento percibida por los pacientes en fisioterapia: validación al español del cuestionario OPTIMAL = Movement ability reported by patients in physiotherapy: validation of the Spanish version of the OPTIMAL questionnaire

“…Los autores achacaron la menor sensibilidad de esta sub-escala al menor número de ítems que la componen. La mayor sensibilidad del OPTIMAL fue a las 4 semanas de tratamiento.En otro estudio publicado recientemente, Riddle et al176 analizaron las propiedades psicométricas del OPTIMAL, también mediante la TCT, sobre una muestra de 1.030 pacientes afectados de trastornos músculo-esqueléticos. Según estos autores, las dos dimensiones de dificultad y confianza del OPTIMAL se superponen y miden constructos demasiado similares, con una alta correlación entre ellas.…”

“…Quizás por este motivo la pregunta relacionada con la dificultad resulta de mayor facilidad de comprensión que la de confianza.Las dos escalas, dificultad y confianza, están pensadas para su administración por separado, como dos cuestionarios independientes, en función de qué constructo se desee medir en una situación determinada. Según Riddle et al176 las dos escalas se solapan entre ellas, mientras que Guccione y Mielenz162 , tal y como se recogió en el marco teórico (apartado 1.4), afirman que son dos constructos diferentes relacionados con el movimiento que deben ser puntuados por separado.En nuestros análisis, se encontraron diferencias significativas en las puntuaciones obtenidas a través de ambas escalas. El OPTIMAL confianza mostraba en casi todos los análisis valores más altos (menor confianza en la capacidad para realizar los movimientos) que el OPTIMAL dificultad, tanto en la puntuación total como en la puntuación de cada sub-escala.…”