Only a limited number of the identified instruments for the assessment of impairments is both reliable and valid .
The objective of this study is to provide a critical overview of available instruments to assess impairments in patients with rheumatic disorders , and to recommend reliable and valid instruments for use in allied health care and rehabilitation medicine .
Evaluation of joint mobility in rheumatoid arthritis trials: the value of the EPM-range of motion scale.
OBJECTIVE Evaluation of joint range of motion ( ROM )  is important in the therapeutic approach to patients with rheumatoid arthritis ( RA ) . The reliability , construct validity and sensitivity to change of the Escola Paulista de Medicina (EPM)--range of motion scale that measures 10 distinct movements of small and large joints were examined . METHODS Fifty patients with active RA who were participating in an inpatient multidisciplinary treatment program were examined by 2 investigators . Twenty-five of the patients were examined both at admission and at discharge from the hospital . RESULTS The mean EPM-ROM score at study entry was 11.52 ( SD + /- 3.80 ) . The intra and inter-observer reliability of the EPM-ROM scale was high , with correlations of r = 0.91 and r = 0.85 , respectively . There was a good correlation between the EPM-ROM scale and measures of functional ability . Correlations with measures of disease activity were poor . After a mean duration of the treatment program of 4.2 weeks , patients generally improved in variables of functional status and disease activity . The improvement of the EPM-ROM score ( mean difference 1.58 , 95 % CI 0.84 - 2.32 ) was generally larger than improvement in other variables of functional status . CONCLUSION The EPM-ROM scale is a reliable instrument , and according to its correlation with measures of functional status , relevant to the performance of activities of daily living . It showed a good response to improvement of functional status and disease activity and was more sensitive to changes than other variables of functional status
Only a limited number of the identified instruments for the assessment of impairments is both reliable and valid .
The objective of this study is to provide a critical overview of available instruments to assess impairments in patients with rheumatic disorders , and to recommend reliable and valid instruments for use in allied health care and rehabilitation medicine .