Purpose
APTA's Outpatient Physical Therapy Improvement in Movement Assessment Log (OPTIMAL) is an instrument that measures difficulty and self-confidence in performing 22 movements that a patient/client needs to accomplish in order to do various functional activities. OPTIMAL 1.1 has been updated from the original version to increase clinical utility. This includes adding the clinically relevant item of standing and providing changes to scoring instructions to increase clinical utility. These changes will assist patient and physical therapist discussion toward identifying the primary goal for the episode of care.
Acronym
OPTIMAL
Area of Assessment
Balance – Non-vestibular
Coordination
Dexterity
Functional Mobility
Gait
Upper Extremity Function
Assessment Type
Patient Reported Outcomes
Administration Mode
Paper & Pencil
Cost
Free
Diagnosis/Conditions
- Arthritis + Joint Conditions
- Brain Injury Recovery
- Pain Management
- Parkinson's Disease & Movement Disorders
- Pulmonary Disorders
- The Outpatient Physical Therapy Improvement in Movement Assessment Log (OPTIMAL) is an instrument that measures difficulty and self-confidence in performing 22 movements that a patient/client needs to accomplish in order to do various functional activities.
- Scoring is relatively simple, and it can be done in 3 different ways:
- 1) The most expedient way to calculate a total score is to sum the responses (marked on a 1 to 5 scale) across all 22 items on difficulty and on self-confidence upon both the patient’s/client’s admission (baseline) and discharge from physical therapy (final). Then subtract the final sum from the baseline sum. The higher the change score, the more the patient has improved. If a particular item on the OPTIMAL is marked as "Not Applicable," then this item should be dropped completely from the overall scoring. For example, suppose that two items are marked "Not Applicable." The best possible score on "Difficulty" or "Self-confidence" for this patient would be "20" (1 x 20 items) and the worst possible score would be "100" (5 x 20 items). Do not add "9" to the score ("9" is an arbitrary coding convention to distinguish the item from missing data if you are entering information into a database).
- 2) The instrument includes a question that asks the patient/client, “From the above list [referring to the 22 items], choose the 3 activities you would most like to be able to do without any difficulty,” which may also provide clinically meaningful information. The therapist can calculate a specific item score to appraise the changes between admission and discharge scores on these three items.
- 3) Finally, The instrument includes a question that asks the patient/client, “From the above list of 3 activities please indicate the primary activity that you would most like to be able to do without any difficulty,” which may also provide clinically meaningful information. The therapist can calculate a specific item score to appraise the changes between admission and discharge scores on the primary goal. This scoring method allows the therapist to determine the outcome of treatment on the ability to perform the movement that is most important to the patient/client. This method particularly aids in the clinical decision-making process.
Required Training
No Training
Instrument Reviewers
Deb Kegelmeyer PT, DPT, MS, GCS & the PD EDGE Task Force of the Neurology Section of the APTA
ICF Domain
Body Function
Activity
Measurement Domain
Motor
Professional Association Recommendation
Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.
For detailed information about how recommendations were made, please visit:
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Abbreviations:
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HR
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Highly Recommend
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R
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Recommend
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LS / UR
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Reasonable to use, but limited study in target group / Unable to Recommend
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NR
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Not Recommended
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Recommendations Based on Parkinson Disease Hoehn and Yahr stage:
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I
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II
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III
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IV
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V
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PD EDGE
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LS/UR
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LS/UR
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LS/UR
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NR
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NR
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Recommendations for entry-level physical therapy education and use in research:
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Students should learn to administer this tool? (Y/N)
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Students should be exposed to tool? (Y/N)
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Appropriate for use in intervention research studies? (Y/N)
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Is additional research warranted for this tool (Y/N)
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PD EDGE
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No
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No
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No
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Not reported
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Considerations
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