Clinicians’ and patients’ impressions of change in motor performance as potential outcome measures for clinical trials

Abstract

A cross-sectional descriptive study was undertaken. The overall objective was to explore the potential usefulness of clinicians' and patients' impressions of change in motor performance for clinical trials. Specifically, the aim was to compare clinicians' and patients' impressions of change in motor performance with standardized outcome measures in people with spinal cord injury (SCI). Spinal injury units, Sydney, Australia. Thirty people undergoing rehabilitation after recent SCI were recruited. They were assessed on two occasions separated by between 1 and 5 months. On both occasions, patients were assessed sitting unsupported (n = 25), transferring (n = 23) and walking (n = 12) using standardized outcome measures. On the second occasion, patients rated their impressions of change in each of the three motor tasks since their initial assessment. A 15-point scale was used. In addition, patients were videoed performing the three motor tasks on the two occasions. Two clinicians with SCI experience independently viewed the pairs of videos and rated their impressions of change using the same 15-point scale. Clinicians' and patients' impressions of change were compared with each other and to the standardized objective measures. Clinicians' and patients' impressions of change were greater than change measured with standardized objective measures for all three motor tasks (P<0.01). In addition, patients' impressions of change were greater than clinicians' impressions of change for transferring, but comparable for unsupported sitting and walking. Clinicians' and patients' impressions of change in motor performance may have potential for evaluating treatment effectiveness in clinical trials.