Documents Goldstein, Barry 1 results

This report examined different perspectives of upper extremity (UE) rehabilitation outcome in order to critically analyze various approaches to effectiveness evaluation. The impact of the patient's perspective and expectations on the outcome of treatment was discussed. Contributions made to classification bias from etiologic and anatomic heterogeneity were outlined. A conceptual framework was developed which relates the impact of interventions on the disease, impairments, the person and the environment. The worker's own perceptions of UE dysfunction and the expectations that person has were explored using various individual based designs of outcome quantification, including an illustration of the tension between individual and group perspectives on outcome. A model for population based outcome evaluation was presented which addresses diagnosis specific as well as individual goal specific evaluation. The authors suggest that to successfully measure the outcome of the rehabilitation process, one must take into account the achievement of individual goals as well as the objective scalar quantification of impairments, disabilities, and handicaps that are comparable between groups.