Outcomes and Outcome Measures in Seating and Mobility: Current Practice

Canadian Clinical Blog by Sheilagh Sherman, BA, BHScOT, MHM, OT Reg. (Ont.) - Sunrise Medical

When we practice in seating and mobility, are we measuring outcomes when working with clients? Or are we describing outcomes? What do our fellow therapists consider when prescribing seating and mobility for individuals? This month, Clinical Corner will distinguish between outcomes and outcome measures. In addition, Clinical Corner will highlight some of the results of a survey that was conducted regarding the use of outcomes and outcome measures with therapists practicing in seating and mobility in Canada.


According to Mosby’s Medical Dictionary (2009), an outcome is “The condition of a patient at the end of therapy or a disease process, including the degree of wellness and the need for continuing care, medication, support, counseling, or education.” An outcome can be considered the end result or the consequence of an intervention. It implies a description, which may or may not be quantifiable.

Mosby’s Medical Dictionary (2009) defines an outcome measure as “A measure of the quality of medical care, the standard against which the end result of the intervention is assessed.” An outcome measure implies a tool that can be used to provide an objective measurement that may quantify and validate the result of an intervention.

Current Practice

If you are a clinician who participated in my Cyber Series of webinars recently, you will know that I asked participants to complete one of two on-line surveys of open-ended questions, asking about the use of outcomes and outcome measures. Response was limited, making generalization difficult; however, there was representation from across the country – from British Columbia to Newfoundland to the Yukon. Occupational therapists and physiotherapists who participated in the surveys reported working in a variety of clinical settings, including community, long term care, acute care, Veterans Affairs, in-patient rehab and a seating clinic. Only one respondent reported currently using standardized outcome measures and drew from a list of multiple outcome measures, depending upon what was relevant to evaluate for a given client. The remainder of the respondents described using outcomes to know that the wheelchair and/or seating they were trialing (or prescribed) was appropriate or working for a client. Most therapists reported they considered multiple outcomes for each client. Let’s review the outcomes the therapists from the survey most commonly reported using.

Survey Results – Outcomes Used in Seating and Mobility

Targeted outcomes/goals

Most therapists from the survey reported that they set targeted goals with their clients at the outset of service delivery. Some therapists used wording such as ensuring the goals of the client, goals of the intervention, or goals of the referral have been met. Whatever language was used, establishing SMART (specific, measurable, attainable, realistic, and within a time-frame) goals with clients helped therapists to set parameters to know whether or not the goals had been met.

Ensuring proper fit/set-up/programming of wheelchair and/or seating

The next most common response to the survey was regarding the theme of equipment set-up for the client. This included ensuring the proper fit and set up of the wheelchair and seating system and ensuring the programming parameters of a power wheelchair were appropriate for a particular client.

Ensuring correct positioning/anatomical position/good or tolerated posture

The next theme that emerged from the survey results was regarding positioning. Many therapists reported that they ensure correct positioning for an individual client as an outcome of the intervention. The terms anatomical position and good or tolerated posture also were used.

Function is maintained or improved in environment

Some therapists commented on addressing function as an outcome of seating and mobility. Therapists identified specific outcomes, such as propulsion in a manual wheelchair, operation of a power device, transfers, access to tables, and physiological function.

Reported comfort/sitting tolerance/pain level

Therapists commented that the client’s reported level of comfort or pain is taken into account when addressing seating and mobility needs. Other therapists used the language of sitting tolerance, which provides a quantifiable measure.

Client satisfaction/perceived issues/feedback

Other therapists reported that they take into account the client’s reported satisfaction with the equipment and any feedback, including any perceived issues the client identifies, as part of the outcomes that are assessed to determine if the prescription is appropriate for a client. One therapist noted that she pays attention to the body language and gestures of her clients to gain feedback when the client is unable to communicate in other ways.

Feedback from staff and family

Therapists also seek and pay attention to feedback they receive from staff and from family members of clients.

Subjective quality of life

The client’s report on their quality of life with the use of the prescribed device was listed as another outcome that a therapist considers in seating and mobility.

Skin integrity

Some therapists reported that they assess skin integrity to ensure that the prescription is appropriate for the client. One therapist commented that she uses pressure mapping, which quantifies the magnitude of pressure on the seated surface.


There is a subtle difference between outcomes and outcome measures in seating and mobility. Whereas outcomes may include subjective descriptions, outcome measures can be objective, quantifiable means of validating interventions. The results of an on-line survey suggest that many therapists involved in seating and mobility in Canada consider outcomes when working with clients. Some outcomes, such as pressure mapping, sitting tolerance and using SMART goals, allow for some aspect of measurement to occur. A future Clinical Corner article will provide additional details on outcome measures that help to provide objective quantification of outcomes such as those mentioned in this month’s article.


  1. Outcome. (2009) Mosby's Medical Dictionary, 8th edition. Retrieved from https://medical-dictionary.thefreedictionary.com/outcome
  2. Outcome measure. (2009). Mosby's Medical Dictionary, 8th edition. Retrieved from https://medical-dictionary.thefreedictionary.com/outcome+measure

As always, please provide your comments, questions, and suggestions regarding Clinical Corner. Please email me at Sheilagh.Sherman@sunmed.com. I look forward to hearing from you!

Sheilagh Sherman BA, BHScOT, MHM, OT Reg. (Ont.) - Clinical Education Manager, Canada

Sheilagh Sherman, BA, BHScOT, MHM, OT Reg. (Ont.)

Sheilagh Sherman joined Sunrise Medical Canada in 2010 as a Clinical Educator. Prior to joining Sunrise, Sheilagh gained extensive clinical experience working in a variety of settings, including neurological rehabilitation, complex continuing care, and community rehabilitation. As the Clinical Education Manager, Sheilagh is a clinical resource for therapists across Canada involved in seating and mobility. She leads workshops, seminars, and webinars on the clinical aspects of seating and mobility. In addition, Sheilagh has presented at national and international conferences on seating and mobility.

Sheilagh also has an educational background that makes her well suited to the role of Clinical Education Manager. Sheilagh earned a Bachelor of Arts degree in Political Science from the University of Toronto in 1988, which enables her to understand healthcare policy and policy changes. Sheilagh graduated with a Bachelor of Health Sciences (Occupational Therapy) degree from McMaster University in 1994. In 2012, Sheilagh earned a Certificate in Adult Education/Staff Training from Seneca College. She applies adult learning principles to the workshops she leads. Finally, she also has a Master of Health Management (MHM) degree from McMaster University after graduating in 2015. Courses that Sheilagh completed during the MHM degree, such as Knowledge Translation, Evaluating Sources of Evidence, and Quality & Safety in Healthcare, assist Sheilagh in using an evidence-based approach in her work.

In her free time, Sheilagh enjoys running, in addition to practicing yoga.

Date: 2019-06-28

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