The tools of disability outcomes research functional status measures

Objective: To review the major functional status measures currently used in rehabilitation research, including the domains and scope of functional status measures, as well as the psychometric properties of selected functional status measures and their use in adult rehabilitation populations. Data Sources: Measures of physical functioning widely used in rehabilitation research. Study Selection: Major generic measures included the following activities of daily living and instrumental activities of daily living: the FIM(TM) instrument, the Katz Activities of Daily Living Scale, the Level of Rehabilitation Scale, the Barthel index, and the Patient Evaluation and Conference System. Measures were evaluated based on published evidence of validity, reliability, and sensitivity. Data Extraction: Measures were chosen on the basis of the amount and quality of published research on the functional measures widely used in rehabilitation medicine. Independent research of computer databases and reviews of functional measures were conducted to determine suitability for inclusion. The quality and validity of the measures were assessed using standard psychometric guidelines. Data Synthesis: Measures were evaluated based on published evidence of validity, reliability, sensitivity response and administrative burdens and instrument bias. Each criterion was graded on a 3-point scale reflecting the level of evidence. Conclusion: Researchers in the field of disabilities research need to consider carefully study objectives when measuring physical functioning in people with disabilities.