The impact of standardized balance measurement on physical therapist decision-making in acquired brain injury: a survey

Abstract

ABSTRACT Background The use of balance outcome measures (OM) is proposed to enhance physical therapy services and patient outcomes. Objective Explore current practices of balance OM use and OM’s role in United States physical therapists’ decision-making with patient’s acquired brain injury (ABI). Methods Cross-sectional survey utilizing snowball sampling, n = 373. Survey items required ranking agreement with statements on Likert scale. Multinomial logistic regression used to determine the relationship between survey answers and participant characteristics. Results Ninety-three percent of therapists reported using outcome measures with patients with ABI. Those who reported not using outcome measures with patients with ABI were significantly different on setting, primary patient population, APTA section membership, and ANPT membership. All respondents who primarily treated neurologic diagnoses used outcome measure with clients with ABI, compared to 87% of respondents who worked primarily with orthopedic clients. Comfort, equipment availability, and psychometric properties were the most frequent reasons for choosing a measure. Therapist decision-making was impacted by outcome measures; this frequency was dependent on practice setting, primary patient population, and specialty certifications. Conclusions Physical therapists use a low diversity of outcome measures to assess balance. Respondents rated psychometric properties as more important than past published research. This is the first study to demonstrate that outcome measures play a role for most United States PTs in decision-making in all stages of the patient management model including identification of problems, diagnosis, prognosis, intervention selection, termination of services, and discharge planning, as well justifying service delivery.