The BACPAR outcome measures toolbox: a step towards standardising outcome measures for physiotherapist working with lower limb amputees

Scopes, Judy; Tisdale, L.; Cole, Marie; Hayes, Summer D.; Ostler, Chantel; Cummings, J.; Golland, N.

doi:10.1016/j.physio.2015.03.1293

Cited by 6 publications

(5 citation statements)

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“…Several authors exploring measurement tools have raised the issue that there is no consensus around which tools should be used. 28,29 This plethora of tools and absence of consensus also seems to be evident in the current UK health policy and professional guidance, where long lists of OMs are suggested for use in the Prosthetic National Service Specification, 30 the NHS Microprocessor Knee Policy, 5 the British Associations of Chartered Physiotherapists in Amputation Rehabilitation OMs toolbox, 18 and the British Association of Prosthetists and Orthotists OM guidance. 17 These resources seem to recommend the use of many different measures, with little consistency, and often include different measures that capture the same outcome domain.…”

Section: Resultsmentioning

confidence: 99%

“…4 NHS policy 16 and prosthetic rehabilitation professional bodies, such as the British Association of Prosthetists and Orthotists and the British Associations of Chartered Physiotherapists in Amputation Rehabilitation, have issued advocacy and guidance on OMs in clinical services. 17,18 However, the use of OMs has yet to become embedded, and there is currently no UK outcome data collection initiative capturing the inherent usefulness of this information after amputation. 4 Despite the common view that it is due to ambivalence of clinicians 19 and a resistance to change and innovation among service providers, 20 a systematic review by Duncan and Murray 4 exploring barriers and facilitators to OM use among allied health professionals (AHPs) suggests this is not the case.…”

Section: Introductionmentioning

confidence: 99%

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From outcome measurement to improving health outcomes after lower limb amputation—A narrative review exploring outcome measurement from a clinical practice perspective

Ostler

Scott

Sedki

et al. 2022

Prosthetics &Amp; Orthotics International

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Outcome measurement is essential to understand the impact of clinical interventions and the performance of services. Despite national and professional body encouragement, and successful examples of system level outcome measurement within some health care settings, many barriers still exist preventing outcome measurement from becoming embedded in clinical practice. This paper presents a narrative review which aims to describe the state of the outcome measurement evidence base in prosthetic rehabilitation, as applied in clinical practice, with a view to identifying areas for future work aimed at making outcome measurement in prosthetic rehabilitation a meaningful reality. A literature search of four databases was undertaken, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis principals appropriate to narrative reviews, and using the search terms outcome, measur*, tool, scale, instrument, prosthe*, amput* and limb loss. A total of 1116 papers were identified. Following screening 35 papers, focusing on four main themes, were included in the review. Themes were: 1) What outcome domains should be measured? 2) How can these outcome domains be measured? 3) What are the barriers to outcome measurement? and 4) What can be learnt from examples of ROM in prosthetic rehabilitation?Findings suggest that successful outcome measurement is multifaceted. Understanding and embedding value at every step appears to be key to success. Addressing the questions of ‘what’ outcome domains to measure and ‘how’ to measure them, may help establish consensus. Routine outcome measurement practice at the clinical level should ensure data collection is valuable to clinical practice, makes use of information technology solutions and has organisational engagement.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

From outcome measurement to improving health outcomes after lower limb amputation—A narrative review exploring outcome measurement from a clinical practice perspective

Ostler

Scott

Sedki

et al. 2022

Prosthetics &Amp; Orthotics International

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show abstract

“…31 At a clinical level, both the British Association of Chartered Physiotherapists in Amputee Rehabilitation (BACPAR) and BAPO have published guidance on the use of OMs in clinical practice. 1,2 However, both sets of recommendations focus on the selection of outcome measurement tools, listing up to 11 different measures, and do not base this advice on an understanding of what outcomes are important to capture following prosthetic rehabilitation and why. Although these clinically useful documents take steps towards addressing the well documented lack of consensus, widespread use remains an issue.…”

Section: Discussionmentioning

confidence: 99%

“…It is a source of discussion within clinical meetings and specialist interest groups and can often be found as a specific topic stream on the programmes of national and international conferences. However, despite professional body 1,2 and national health policy encouragement, 3 outcome measures (OMs) are still not routinely used and have not become embedded in clinical practice. 4 Outcome measurement can be better understood by breaking the term down into the outcome being measured and the measurement tool used for the task.…”

Section: Introductionmentioning

confidence: 99%

From outcome measurement to improving health outcomes following lower limb amputation - making outcome measurement work from a clinical practice perspective

Ostler¹,

Scott²,

Sedki³

et al. 2020

Preprint

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Background: Outcome measurement is essential to understand the impact of clinical interventions and the performance of services. Despite national and professional encouragement outcome measurement has failed to become embedded in clinical practice and its value continues to be questioned. Objectives: To address the outcome measurement debate within lower limb prosthetic rehabilitation and provide a critical synthesis of the evidence surrounding the discussion applied within the clinical context of the UK National Health Service (NHS).Study Design: Narrative review Methods: The authors drew on over 20 years clinical experience in prosthetic rehabilitation to synthesise and critique the outcome literature across a breadth of healthcare services. A narrative review methodology was selected to give voice to the clinical narrative thread.Results: This review addresses why we should measure health outcomes, the health care delivery and organisational scenarios in which outcome measurement can be beneficial and explores where lessons can be learnt for prosthetic rehabilitation from approaches in different specialities. The current outcome measurement literature within prosthetic rehabilitation is critiqued and we discuss the issues facing this field in the future.Conclusions: The dilemma of successful outcome measurement in clinical practice is multifaceted. Understanding and embedding value at every step is key to success. Addressing the questions of `why’, `what’ and `how’ we measure outcome will move us closer to a national consensus. Routine outcome measurement implementation at the clinical level must ensure data collection is valuable to clinical practice, makes use of IT solutions and has all important organisational buy in.

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“…Within prosthetic rehabilitation several clinical interest groups, such as the British Association of Physiotherapists in Limb Absence Rehabilitation (BACPAR) and the International Society of Prosthetics and Orthotics (ISPO), have attempted to increase health care professional engagement by publishing recommended outcome measures for use in clinical settings [5][6][7][8]. However, numerous outcome measures are included in the recommendations, with different measures proposed by different professional groups.…”

Section: Introductionmentioning

confidence: 99%

Development of the ECLIPSE model of meaningful outcome domains following lower limb amputation and prosthetic rehabilitation, through systematic review and best fit framework synthesis

Ostler,

Dickinson,

Metcalf

et al. 2024

Preprint

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Background Little is known about which outcome domains characterise meaningful recovery following prosthetic rehabilitation and should be measured. Our previous qualitative work developed a conceptual model of outcome domains which are meaningful to patients. This qualitative synthesis aims to develop that model by exploring views and experiences of recovery captured in the limb loss literature, and use these to produce a second iteration of the model describing outcome domains of importance following prosthetic rehabilitation from the patient's perspective. Methods Systematic searches were conducted using CINAHL, Psychinfo and Web of Science from 2011 to early 2023. Studies with a qualitative design focusing on views and experiences of lower limb prosthetic users were eligible for inclusion. Quality was assessed using the CASP tool. 'Best Fit' framework synthesis was used to synthesise the evidence and develop the conceptual model. Results 40 studies were included, describing the experiences of 539 participants. Data supported the pre-existing conceptual model and led to development of four of the five domains. The newly named ECLIPSE model describes meaningful outcome domains as 1) Being able to participate in important activities and roles, 2) Participating in the way I want to, 3) My prosthesis works for me, 4) If I am in pain, I can manage it, and 5) I am able to accept my new normal. Studies came from 15 countries showing good coverage of high-income settings. Few participants from low-and-middle-income countries were included, it is unclear if the ECLIPSE model describes outcome domains of importance in these settings. Conclusions This synthesis provides a rigorous foundation for understanding outcome domains of importance following lower limb prosthetic rehabilitation from the patient's perspective. The ECLIPSE model is an accessible representation of recovery which could direct rehabilitation programmes, as well as inform the evaluation of prosthetic care through the selection of outcome measures.

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The BACPAR outcome measures toolbox: a step towards standardising outcome measures for physiotherapist working with lower limb amputees

Cited by 6 publications

References 0 publications

From outcome measurement to improving health outcomes after lower limb amputation—A narrative review exploring outcome measurement from a clinical practice perspective

From outcome measurement to improving health outcomes after lower limb amputation—A narrative review exploring outcome measurement from a clinical practice perspective

From outcome measurement to improving health outcomes following lower limb amputation - making outcome measurement work from a clinical practice perspective

Development of the ECLIPSE model of meaningful outcome domains following lower limb amputation and prosthetic rehabilitation, through systematic review and best fit framework synthesis

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