Measuring Up To Our Full Potential
Tampa--"Guidelines will reveal the value of physical therapy
services." So said Edelle C. Field-Forte, PT, PhD of the University of Miami
Miller Medical School at the 17th Annual John H. P. Maley Lecture today. The lecture, named for Maley, a past president of the Foundation for Physical
Therapy, honors a physical therapist who has made significant contributions to
the profession in the area of clinical practice. Dr. Field-Forte called the lectureship, "the highest honor I
The ability to standardize is critical in our lives. Dr.
Field-Forte asked the audience to imagine life without building codes or
traffic laws. A standard, by her definition is "a framework of agreements to
which relevant parties adhere to ensure performance and quality." Yet in the
physical therapy field, she argued that there is a lack of good standardization
in several areas. Her talk focused
on the lack of standardized outcome measurements and its impact on the
The idea that standardized outcomes measurements is a good
one has been around for a while. In the late 1980s, an APTA task force convened
to address the issue. Yet, the theory has not translated into practice. In a
2009 survey, 48% of US PTs admitted to using standardized outcome measurements.
Of the PTs who did not, 49% had no plans to start. So, what are clinicians
using instead to determine if their interventions worked? Clinical impressions,
informal assessments, clinical judgment and intuition are all options. Dr.
Field-Forte cautioned subjective assessments can be misleading. "We can be
fooled by our frame of reference."
For therapists who do use a standardized outcome
measurement, the choice of which scale is arbitrary. For example, the Berg,
Tinetti and Timed Up and Go are all valid ways to measure mobility and balance.
Differences in how these tests measure make it difficult to compare their
Dr. Field-Forte argued, "The true value of physical therapy remains hidden because
we can't measure the effects of our treatments." She told the audience that a
profession-wide commitment to assessment with valid measures is imperative. "The
structure is in place. All we need is the commitment."