In the previous chapter, you learned that the first step in evidence-based practice is to ask a meaningful question. You also learned to ask this question in a format that identifies the patient of interest, the intervention of interest, the treatments compared, and the target outcome. Once you had framed your question, the next step was to identify and assess articles to determine whether they could answer your question, including assessing these articles for validity, relevance, and applicability to your patients or clients.
You also learned that people have different sets of goals or values. These may differ widely from your values and goals as a professional. The goals and values may also differ among the clients you serve. When asking questions and determining the needs of your clients, these factors have to be considered. Thus, you learned that the patient's priorities are important for an effective intervention. You learned that the cultural context of a person's life affects the value of potential treatment options. Finally, you have been encouraged to consider the disease's stage and trajectory when framing a question, if it applies.
Now that you can frame the question, much of what is left relates to the research process. You will learn how research is conducted and how evidence is sorted. This knowledge is essential to understand if the answer to your question is to have meaning. Measurement and research are both multifaceted, and subsequent chapters explore the topics in more depth.
This chapter focuses on the measurement of health and performance outcomes. Health is a complex idea, and models of disablement were developed to address this complexity. These models help the practitioner and the patient or client think about what is important to the patient's health. Several models exist, each with advantages and disadvantages. The models imply that the different facets of health can be measured but that no single measure can capture all aspects of health. You will then learn that a variety of outcomes should be used simultaneously to capture as many health dimensions as possible. Included are measures that capture information important to both the patient (or client) and the practitioner and that consider the patient's or client's values. It will become apparent that research that uses measures focused on a single facet of health provides an incomplete picture of a treatment's value.
In contrast, performance-related outcomes are less structured. They can be across all the domains of exercise and sport science, and they are specific to the individual goals of the client. Because these outcomes are less structured, there is increased burden on practitioners to make sure that the outcomes examined are applicable to their clients. We will discover that norms exist for many of these outcomes so that a proper evaluation can be ...