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TRAUMATIC BRAIN INJURY EDGE

TBI EDGE Process:

  • Measures selected for review were compiled from literature review, measures recommended by the Common Date Elements TBI Workgroup, measures recommended by the APTA Educational consensus group and  measures in Rehabilitation Measures Database
  • The outcome measures selected for inclusion represented all domains of the ICF:  body structure/function, activity, and participation.  Self-report measures and performance measures were included.
  • A pair of task force members completed the initial review of each measure.  The psychometric properties of the measures were reviewed using a modified EDGE (Evidence Database to Guide Effectiveness) template (a format recommended by the APTA EDGE task force).  The taskforce also considered the clinical utility of a measure.
  • The taskforce collaborated with the Rehabilitation Measures Database (RMD) in the outcome measure review process.  As outcome measures were reviewed, existing RMD summaries were also reviewed.  New summaries were created by the task force if a RMD summary did not exist. The EDGE documents and RMD documents were designed to be used together.  EDGE documents provide the recommendations for use in different practice settings, entry-level PT education and in research.  The description, psychometric and clinical properties of the measure are on the RMD. 
  • Recommendations for use of an outcome measure were rated on a 4 point ordinal scale:

                     4= highly recommended; the outcome measure has excellent psychometric properties and clinical utility

                     3= recommended; the outcome measure has good psychometric properties and good clinical utility

                     2= reasonable to use, but limited study in target group; the outcome measure has good or excellent psychometric properties and clinical utility in a related population, but insufficient study in target population to support higher recommendation. *

                     1= do not recommend; the outcome measure has poor psychometric properties and/or poor clinical utility

                     *Please note the difference in this rating definition as compared to earlier EDGE task forces (MS and Stroke)

  • A modified Delphi process was used by the entire task force to reach consensus regarding the final recommendations.

RECOMMENDATIONS

  • Recommendations for use of each outcome measure reviewed were categorized by practice setting: acute care/emergency department, in-patient rehab, outpatient (including day rehab and transitional living), long term acute care/skilled nursing facility and home health as well as by ambulatory status (complete independence, mild dependence, moderate dependence, severe dependence). 
  • Recommendations for each outcome measure to entry level PT education were also included. Measures were characterized as those that students should learn to administer, should be exposed to, or are not recommended.
  • Finally, measures were categorized as being recommended or not recommended for use in research.

Click here for completed EDGE documents of all the outcome measures reviewed, which contains detailed information on the psychometric properties of the outcome measures and references.

One page documents summarizing recommendations:

In addition; there is an alphabetical summary page and summary page based on ICF classification.

TBI EDGE Members:

Karen McCulloch, PT, PhD* (Co-Chair)
The University of North Carolina at Chapel Hill, Chapel Hill, NC

Anna de Joya, PT, DSc* (Co-Chair)
TIRR Memorial Hermann, Houston, TX

Erin Donnelly, PT, MSPT*
Kessler Institute for Rehabilitation, Saddle Brook, NJ

Kaitlin Hays, PT, DPT
Craig Hospital, Denver, CO

Tammie Keller Johnson PT, DPT, MS
Casa Colina Centers for Rehabilitation, Pomona, CA

Coby Nirider, PT, DPT
Touchstone Neurorecovery Center, Conroe, TX

Heidi Roth, PT, DHS*
Rehabilitation Institute of Chicago, Chicago, IL

Sue Saliga, PT, MS, DHSc
Oakland University, Rochester, MI

Irene Ward, PT, DPT*
Kessler Institute for Rehabilitation, West Orange, NJ

*All the Physical Therapists above are Board Certified Neurologic Clinical Specialists.

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