Objective:: Self-report functional status scales and questionnaires can be clinically important measures of patient outcome in physical therapy. This paper reviews the application and utilization of such measures in the area of obstetric physical therapy and presents, where available, information on the psychometric characteristics of these measures.
Study Design:: Literature review via Cinahl and Pubmed databases, author queries of advanced practitioners in the field.
Background:: Physical therapists who specialize in women's health commonly treat pregnant women with back and pelvic-ring pain as well as counsel and advise women about activity re-integration after prolonged bed rest for high risk pregnancy. In recent years research into these areas has increased. Review of the utilization of pre-established, validated outcome measures used in such studies has yet to be conducted. Development of population-specific measures appropriate for clinical or research use with obstetric clients in PT has not occurred. The validation of commonly used functional outcome measures and tools for this specific population has also not occurred.
Methods:: A Data Base search using common terms in obstetric physical therapy was conducted with focus on self-report functional outcome measures specific to the population and to those generic tools appropriated to the population. MESH terms such as: 'outcome in pregnancy,' 'physical therapy (PT) and pregnancy-related back pain,' 'high risk pregnancy maternal outcomes,' 'bed rest and postpartum function' were used. Published research on such tools was examined for validity, reliability, and responsiveness to clinical change.
Results:: Twenty tools demonstrating adequate reliability and validity were found to be routinely used in research related to physical therapy for back or pelvic-ring pain during pregnancy. The search did not reveal any studies that attempted to develop functional outcome tools specific to clients seen in physical therapy clinics for pregnancy or postpartum-related back or pelvic-ring pain. In the pregnancy population, the search found 2 population-specific functional measurement tools related to activity level. The search found no evidence of general health measures, disability questionnaires, pain scales, or quality of life tools validated for the obstetric population.
Conclusions:: Researchers use validated and reliable self-report functional outcome measures to evaluate outcomes in physical therapy for back/pelvic-ring pain in the child-bearing year. No population-specific tools have been developed and the generic tools have yet to be validated on the obstetric population with back and pelvic ring pain. Two tools specific to activity level in pregnant women are reported in the literature.