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Transition to Rehab Management

Functional Outcome Tools

Published July 6, 2012 3:51 PM by Karen Schiff

Within the next few months, it will be necessary to choose a patient as a case report in order to complete my DPT. Initially, I had seriously contemplated using a patient from more than 10 years ago, a young woman who suffered a complex pelvic fracture with an accompanying femoral and obturator nerve palsy. Her return to activity was phenomenal, and perhaps the treatment used could be shared with others to assist similar patients. The only problem is that I hadn't heard of functional outcome tools when she was my patient. Our clinic had not used any formal functional outcome tools until recent years, and I hadn't realized the impact these tools have on the future of our profession.

The tools our clinic uses in PT include the upper- and lower-extremity functional index, the Berg Balance tool, the Oswestry tool, and the Neck Disability Index, just to name a few. In addition, pediatric therapists in PT, OT and ST are utilizing functional outcome tools to formalize a need to continue, or even discontinue, services. Functional outcome tools are used for all patients, and have become quite useful when working with worker's compensation or personal injury patients. Much is being accomplished with case managers who "follow the doctor's orders," where communication is key with the physician and the case manager to determine the necessity of ongoing, fraudulent medical care. Of course, there are those patients who demonstrate improvement at different intervals of time, and the correct timing of performing these tests is necessary to demonstrate continuation of services.

Although there are numerous tools out there to choose from, there seems to be a lack of the same for pelvic floor and TMJ dysfunction. This is what I'm considering as a case report, as well. A patient who suffered a GSW to the head and lost mandibular mobility after prolonged immobilization could add to our body of knowledge in PT, due to the interventions of the surgeon, PT, dentist and ultimately the orthodontist. Several years later, after discharge of this patient from PT, she has returned to working as a baker at a local grocery store and is continuing to work with her team of orthodontists to maximize her recovery. The only documented measurements were ROM when she was being treated more than five years ago. Probably the best choice would be to find a patient who is currently under our care, and apply any and all appropriate outcome tools that would support, or not support, the intervention of PT.

The search for a patient continues. Summer break from school is providing ample time to consider options for a case report. Before we know it, my classmates and I will be back at the books. One more year to go. This should be quite a year!

2 comments

That's a great idea.  From what I've learned from previous students, simpler is certainly better.  I would sure love to help expand on my favorite patients, however!   :)

Karen Schiff July 7, 2012 12:34 PM
COOPER CITY FL

This is just a suggestion but you might want to go for something simple like a hip fracture or mildly impaired stroke.  There are several good measures available for both.  If you pick something lacking measures you are creating more work for yourself.  Unless you want to get your project published in a journal go for simpler so you can devote the time to learning the measure thoroughly and what it tells you.

Toni July 6, 2012 7:15 PM

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