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Prospective Evaluation of the AM-PAC-CAT in Outpatient Rehabilitation Settings

AM Jette, PT, PhD, is Director, Health and Disability Research Institute, School of Public Health, Boston University, 580 Harrison Ave, 4th Floor, Boston, MA 02218 (USA)
SM Haley, PT, PhD, is Associate Director, Health and Disability Research Institute, School of Public Health, Boston University
W Tao, BS, is Graduate Research Associate, Health and Disability Research Institute, School of Public Health, Boston University
P Ni, MD, MPH, is Research Assistant Professor, Health and Disability Research Institute, School of Public Health, Boston University
R Moed, MBA, is President, CRE Care, LLC, Boston, Mass
D Meyers, MBA, is National Director of Trends and Outcomes, HealthSouth Outpatient Services, HealthSouth Corporation, Birmingham, Ala
M Zurek, PT, is Vice President of Clinical Quality, HealthSouth Outpatient Services, HealthSouth Corporation

Address all correspondence to Dr Jette at: ajette{at}bu.edu

Background and Purpose: The purpose of this study was to prospectively evaluate the practical and psychometric adequacy of the Activity Measure for Post-Acute Care (AM-PAC) "item bank" and computerized adaptive testing (CAT) assessment platform (AM-PAC-CAT) when applied within orthopedic outpatient physical therapy settings.

Method: This was a prospective study with a convenience sample of 1,815 patients with spine, lower-extremity, or upper-extremity impairments who received outpatient physical therapy in 1 of 20 outpatient clinics across 5 states. The authors conducted an evaluation of the number of items used and amount of time needed to complete the CAT assessment; evaluation of breadth of content coverage, item exposure rate, and test precision; as well as an assessment of the validity and sensitivity to change of the score estimates.

Results: Overall, the AM-PAC-CAT's Basic Mobility scale demonstrated excellent psychometric properties while the Daily Activity scale demonstrated less adequate psychometric properties when applied in this outpatient sample. The mean length of time to complete the Basic Mobility scale was 1.9 minutes, using, on average, 6.6 items per CAT session, and the mean length of time to complete the Daily Activity scale was 1.01 minutes, using on average, 6.8 items.

Background and Conclusion: Overall, the findings are encouraging, yet they do reveal several areas where the AM-PAC-CAT scales can be improved to best suit the needs of patients who are receiving outpatient orthopedic physical therapy of the type included in this study.

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