Published on July 24, 2014
When a patient presents for their initial consultation, various subjective (as reported by the patient) and objective/clinical outcome measures will be established. These measures will ultimately be used at a later date after a reasonable trial of therapy in terms of gauging progress. Objective outcome measures are clinical features that the clinician deems as relevant to the case. The clinician will attempt a trial of therapy and hope to improve such measures. Examples of objective outcome measures include impaired ranges of motion, and evidence of weakness.
Subjective outcome measures are ones that are reported by the patient. A more thorough and complete list of measures is preferred. The more thorough the list, the easier it will be to determine if there has actually been any progress or not.
Many movements/activities in one’s life can ultimately affect the patient’s symptomatic region. As a result, it is most reasonable to measure one’s progress on a week to week basis (as a whole). As an example, let’s take a patient with knee pain who presents with the following thorough list of symptoms:
- Symptoms were described as intermittent, and either sore (usually) or sharp (rarely) in nature
- Symptoms with stairs (down is worse than up, every time)
- Symptoms with squatting (every time)
- Symptoms with kneeling (every time)
- Symptoms with walking (longer than 30 minutes, every time)
- Symptoms with standing (longer than 20 minutes, every time)
After two weeks of intervention, if the patient’s walking threshold increases such that he/she can now walk up to one hour until symptoms start on at least some occasions in a week (compared with only 30 minutes every time initially as noted above), that would be seen as a sign of improvement. Even though there is still pain, the patient’s walking threshold has noticeably increased from 30-60 minutes on at least some occasions during the week whereby the patient could only walk 30 minutes until pain started every time prior to the initial onset of intervention.
It is imperative that the patient understands how improvement is reasonably gauged. Otherwise, a patient might become discouraged and then deem the treatment unsuccessful when in fact the treatment might actually be helping. In addition, certain factors will affect the recovery timeline. These include age, chronicity, pre-existing medical conditions, and nature of injury.