Functional assessment in physiotherapy. A literature review

Area of Science:

• Physiotherapy
• Rehabilitation Medicine
• Health Services Research

Background:

• Functional assessment is crucial in physiotherapy for evaluating patient progress and outcomes.
• Standardized tools with proven psychometric properties are needed for consistent evaluation.
• The International Classification of Functioning, Disability and Health (ICF) provides a framework for understanding health and disability.

Purpose of the Study:

• To identify evidence-based functional assessment instruments in physiotherapy.
• To determine the alignment of these instruments with the ICF framework.
• To explore the utilization of functional assessment in physiotherapy financing.

Main Methods:

• A comprehensive literature search was conducted in Medline (1990-2005) using keywords related to functional assessment, psychometrics, ICF, and health policy in physiotherapy.
• Two reviewers screened 1,567 studies based on titles and abstracts.
• A final selection of 44 studies reporting on the psychometric qualities of functional evaluation tests was made.

Main Results:

• Forty-four studies provided evidence for the psychometric qualities of functional assessment instruments.
• Identified tests cover major physiotherapy diagnostic groups: musculoskeletal disorders, stroke, elderly, and traumatic brain injuries.
• The selected functional tests align with the body functions and activities domains of the ICF.
• No studies were found that used functional outcomes to justify physiotherapy financing.

Conclusions:

• Validated functional assessment tools exist for key physiotherapy populations and align with the ICF.
• These tools can form the basis for standardizing functional evaluations in community physiotherapy.
• There is a gap in the literature regarding the use of functional outcomes in physiotherapy reimbursement and financing.