Functional assessment measures in medical rehabilitation: current status

A number of reviews of functional assessment instruments have focused primarily on the merits of individual scales. This examination of the status of functional measures looks at conceptual issues underlying scale usage, including the domains of measurement, the criterion problem and assumptions underlying treatment. Work on the properties of measures (standardization, scalability, reliability and validity) is also scrutinized. Because insufficient attention has been devoted to most of these issues, medical rehabilitation lacks a set of measures with widespread utility. Self-care and mobility are included in most functional assessment scales, so agreement on an instrument for measuring these functions would be an important step. Subsequent research could then be directed toward establishing measurement properties and relationships to external criteria. The result would improve communication among professionals and make it easier to relay the benefits of rehabilitation to the public.