Modified Outpatient Physical Therapy Improvement in Movement Assessment Log (mOPTIMAL): A Responsive and Reliable Tool for Patients with Non-Operative Shoulder Pain

Michael A Shaffer; Lisabeth L Kestel; Brian R Wolf; Richard K Shields

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Modified Outpatient Physical Therapy Improvement in Movement Assessment Log (mOPTIMAL): A Responsive and Reliable Tool for Patients with Non-Operative Shoulder Pain

Journal article

Open access

Peer reviewed

Modified Outpatient Physical Therapy Improvement in Movement Assessment Log (mOPTIMAL): A Responsive and Reliable Tool for Patients with Non-Operative Shoulder Pain

Michael A Shaffer, Lisabeth L Kestel, Brian R Wolf and Richard K Shields

The Iowa orthopaedic journal, Vol.40(1), pp.91-99

2020

PMCID: PMC7368525

PMID: 32742214

Appears in Diamond Open Access

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7368525View

Published (Version of record) Open Access

Abstract

Medicare regulations require that physical therapists report functional limitations and severity modifiers utilizing a claims-based data collection tool. The Modified Outpatient Physical Therapy Improvement in Movement Assessment Log (mOPTIMAL) captures key constructs about patient confidence and difficulty but has not been evaluated for responsiveness/ reliability during a routine clinical encounter with patients who have shoulder pathology. The purposes of this retrospective study are to 1) explore if mOPTIMAL changes after a single session with a physical therapist, and 2) determine if the tool is reliable among people with non-operative shoulder pain. We included 106 individuals (58% female; mean age 45.8; range: 18-94 yrs.) with "non-operative" shoulder pathology who were seen in outpatient physical therapy from 2011 to 2012. Subjects completed a mOPTIMAL survey and a pain scale before and immediately after the initial physical therapy visit. The mOPTIMAL is a patient-centered instrument that assesses how much "Difficulty" and "Confidence" a client has in performing a battery of functional tasks. T-tests, Cronbach's Alpha, and Intra-class Correlations were used to assess responsiveness, internal consistency, and reliability, respectively. After a single visit, participants reported improved Confidence with sleeping, dressing/ bathing, throwing, carrying, and lifting (adjusted for ceiling effects; p<0.002) but no change in pain. Cronbach's Alpha and Intra-class Correlations were excellent (0.821-0.923; 0.967, respectively). mOPTIMAL is a reliable and responsive tool with excellent internal consistency. This observational study revealed that patient Confidence may change independent of Pain after a single physical therapy visit. Taken together, the mOPTIMAL appears to be an excellent tool to report severity modifiers in compliance with Medicare regulations. .

United States

Adolescent

Adult

Aged

Aged, 80 and over

Female

Humans

Male

Middle Aged

Outcome Assessment, Health Care - standards

Outpatients

Pain Measurement

Physical Therapy Modalities

Psychometrics

Reproducibility of Results

Retrospective Studies

Shoulder Pain - physiopathology

Shoulder Pain - therapy

Surveys and Questionnaires

Young Adult

Details

Title: Subtitle: Modified Outpatient Physical Therapy Improvement in Movement Assessment Log (mOPTIMAL): A Responsive and Reliable Tool for Patients with Non-Operative Shoulder Pain
Creators: Michael A Shaffer - Department of Rehabilitation Therapies
Lisabeth L Kestel - Department of Rehabilitation Therapies
Brian R Wolf - University of Iowa
Richard K Shields - Department of Physical Therapy and Rehabilitation Science
Resource Type: Journal article
Publication Details: The Iowa orthopaedic journal, Vol.40(1), pp.91-99
Publisher: Dept. of Orthopaedics, The University of Iowa; United States
PMID: 32742214
PMCID: PMC7368525
ISSN: 1541-5457
eISSN: 1555-1377
Language: English
Date published: 2020
Academic Unit: Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science
Record Identifier: 9984294956902771

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