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144 APPENDICES Physiotherapy Observation Anamnesis Goniometry Palpation Muscular testing Visual Analogic Scale Added functional test: Clinical functional assessments Added functional test: Tape measure Lower Extremity Functional Scale Proportion of physiotherapists using functional tests to assess total knee replacement (%) 0 10 20 30 40 50 60 70 80 90 100 n = 263 0 50 100 150 200 250 Number of physiotherapists using functional tests to assess total knee replacement (n) Figure 4.10 Distribution of the functional tests used by Belgian ambulatory physiotherapists to assess total knee replacement. Hemiplegia / Hemiparesis Overall, 294 physiotherapists out of the 367 respondents have indicated the functional tests used to determine the evolution of patients suffering from hemiplegia/hemiparesis. The distribution of functional tests is presented in Figure 4.11. The most frequent functional tests used by Belgian ambulatory physiotherapists to assess patients with hemiplegia/hemiparesis refer to clinical tests carried out by the physiotherapists as part of the clinical examination but not (or almost not) documented in the literature. The most frequent clinical tests used by Belgian ambulatory physiotherapists were, from the most prevalent to the least: observation (95 ± 02%), anamnesis (84 ± 04%), and muscular testing (72 ± 05%). Palpation and Bobath assessment were also clinical tests moderately used in ambulatory practice (47 ± 06% and 26 ± 05%, respectively). Standardised functional assessment tools whose metric properties and quality appraisal have been pretty documented (i.e., Functional Independence Measure, Berg Balance Scale, Functional Assessment Measure, Fugl-Meyer Test, SF-36 scale, and Barthel Index) are rarely used by Belgian ambulatory physiotherapists (cumulated proportion: 10 ± 03%).
KCE reports vol. 40 APPENDICES Physiotherapy 145 Observation Anamnesis Muscular testing Palpation Bobath assessment Functional Independence Measure Berg Balance Scale Ashworth scale Functional Assessment Measure Picard assessment Fugl-Meyer Test SF-36 scale Barthel Index Proportion of physiotherapists using functional tests to assess hemiplegia/paresis (%) 0 10 20 30 40 50 60 70 80 90 100 0 50 100 150 200 250 n = 294 Number of physiotherapists using functional tests to assess hemiplegia/paresis (n) Figure 4.11 Distribution of the functional tests used by Belgian ambulatory physiotherapists to assess hemiplegia/hemiparesis. Gait disorders in elderly people Overall, 309 physiotherapists out of the 367 respondents have indicated the functional tests used to determine the evolution of elderly patients suffering from gait disorders. The distribution of functional tests is presented in Figure 4.12. The most frequent functional tests used by Belgian ambulatory physiotherapists to assess elderly patients with gait disorders refer to clinical tests carried out by the physiotherapists as part of the clinical examination and to standardised functional assessment tools requisite by the INAMI/RIZIV (i.e., Tinetti Balance and Gait Evaluation, 6-Minutes Walk Test). The most frequent functional tests used by Belgian ambulatory physiotherapists were, from the most prevalent to the least: observation (96 ± 02%), anamnesis (85 ± 04%), Tinetti Balance and Gait Evaluation (81 ± 04%), and muscular testing (53 ± 06%). Six-Minutes Walk Test and palpation were also functional tests moderately used in ambulatory practice (40 ± 05% and 35 ± 05%, respectively). Other standardised functional assessment tools not requisite by the INAMI/RIZIV (i.e., One-Leg Balance Test, Timed Get-Up-and-Go Test, Tests d Anticipation Posturale , Functional Reach Test, Berg Balance Scale, Test minimum moteur , and Modified Gait Abnormality Rating Scale) are rarely used by Belgian ambulatory physiotherapists (cumulated proportion: 29 ± 05%).
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