Optimization – Going beyond normalization

MET strives to deliver optimal improvements for our patients and clients. Optimal improvement is defined as:

  1. Achieving improvements in 4 outcome domains which,
  2. Are meaningful (such as an improvement equal or greater than the MDC and/or MID), and
  3. Result in reduced risk for recurrence; improved community independence; and overall healthier individuals.

This third criteria is illustrated in a recent article of Van Onsem and colleagues who identified two outcome measures, range of motion (from the impairment outcome domain) and 6-min walk test (from the objective performance domain) which can predict patient satisfaction with TKA. A cluster of patients whose Improvements were beyond the pre-surgical level are 6–8 times more likely of being satisfied after TKA.

This illustrates the need for clinician not only to strive for normalization but also for optimization.

Van Onsem S et al. Improved walking distance and range of motion predict patient satisfaction after TKA. Knee Surg Sports Traumatol Arthrosc. 2018 Feb 8.

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