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

AA Guccione, PT, DPT, PhD, FAPTA, is Senior Vice President, Practice and Research Division, American Physical Therapy Association, 1111 N Fairfax St, Alexandria, VA 22314-1488 (USA) (andrewguccione{at}apta.org)
TJ Mielenz, PT, PhD, OCS, is Research Faculty, Thurston Arthritis Research Center, and Assistant Professor, Division of Physical Therapy, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
RF DeVellis, PhD, is Research Professor, Department of Health Behavior & Health Education, School of Public Health, and Adjunct Professor, Department of Psychology, College of Arts and Sciences, University of North Carolina at Chapel Hill
MS Goldstein, EdD, is Director of Research Services, Practice and Research Division, American Physical Therapy Association
JK Freburger, PT, PhD, is Research Associate and Fellow, Cecil G Sheps Center for Health Services Research, and Assistant Professor, Division of Physical Therapy, School of Medicine, University of North Carolina at Chapel Hill
R Pietrobon, MD, PhD, is Assistant Research Professor, Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC
SC Miller is Assistant Director of Research Services, Practice and Research Division, American Physical Therapy Association
LF Callahan, PhD, is Associate Professor, Departments of Medicine, Orthopaedics and Social Medicine, School of Medicine; Adjunct Associate Professor, Department of Epidemiology, School of Public Health; and Research Fellow, Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill
K Harwood, PT, PhD, CIE, is Director of Practice, Practice and Research Division, American Physical Therapy Association
TS Carey, MD, MPH, is Director of the Cecil G Sheps Center for Health Services Research; Professor, Internal Medicine and Social Medicine, School of Medicine; and Adjunct Professor, Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill

Address all correspondence to Dr Guccione

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.

Key Words: Actions • Movement • Outcomes • Physical therapy • Reliability • Responsiveness • Validity

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