Physical Therapy Tests in Stroke Rehabilitation
The purpose of this chapter is to present an overview of physical therapy tests used in stroke rehabilitation. The rationale for using tests in perspective of evidence based medicine and the classification of function, introduced by the World Health Organization will also be discussed. Furthermore, the strength and weaknesses with qualitative and quantitative tests are presented and prerequisites for tests in general are discussed. Finally, three tables presenting current valid tests in stroke rehabilitation, in relation to the three levels of the ICF model, are introduced. These tables are meant to give a visual of outcomes and which aspect of care that is being evaluated by the same. Stroke rehabilitation involves a process where the physical therapists, the rehabilitation team and the patient have to discuss goals and what future directions might be considered in view of the stroke event and its consequences. This process often means change, a change from the life one lead before the stroke incidence to a life with a reduced function; this reduction can be varying in degree. The rehabilitation process also involves an evaluation of the clinical condition, planning of a treatment and evaluating the result of treatment. The 14th general meeting of the World Confederation for Physiotherapy (WCPT) defined the profession and the process as follows: “The nature of physical therapy is providing services to people and populations to develop, to maintain and to restore maximum movement and functional ability throughout the lifespan. Physical therapy includes the provision of services in circumstances where movement and function are threatened by the process of aging or that of injury or disease. Full and functional movements are at the heart of what it means to be healthy “. Furthermore: “The nature of the physical therapy process is the service only provided by, or under the direction and supervision of a physical therapist and includes assessment, diagnosis, planning, intervention and evaluation” (World Confederation for Physical Therapy, 2009). There are different ways of evaluating clinical conditions and interventions. Interviews and observation / clinical observation are two important methods (Domholdt 2000). Testing / measuring function is another method. Ideally, the assessment process involves all three; an interview, where the patient´s perceptions of the main problems are at focus, observations of performance, and tests of performance followed by a process of interpreting the information into goals, a treatment plan and continuously evaluate outcome throughout the intervention process (Wade 1992).