fuctional performance. But the fact that this i tem had the lowest level of response may reflect the lack of emphasis placed on it by physiotherapists and/or the team.
Conclusion Attempts t o develop an assessment tool t o provide
consistent and valuable information for audit have been made with the mobil ity index. The functions selected were widely acceptable t o the participants, and the simple scoring system requiring a small investment of t ime encouraged compliance. Stages of assessment were easily and graphically displayed and could be appreciated by other members of the team. Objective goals could be set and progress mapped. Physiotherapists' success at facil i tating goal sett ing was high.
Numerous questions are raised by the project, but in particular further work needs t o be done on the influences and process of contract goal setting; the mos t effective sequence of functional rehabilitation; the relationship between mental and physical function; and developing the assessment tool further t o include dynamic goal changes and achievement that may be necessary.
A larger more formal study is needed t o develop definitive audit, t o control the selection of assessors and subjects, and standardise the assessment procedure.
REFERENCES Department of Health and Social Security (1983). NHS Management
lnquiry (leader of inquiry Roy Griffiths), HMSO. Department of Health and Social Security (1989). Working for
Patients, HMSO. Department of Health and Social Security (1990). NHS and
Community Care Act 7990, HMSO. Graham, H and Livesley, B (1983). 'Can re-admissions to a geriatric
medical unit be prevented?' Lancet, 1, 8321, 404-406. Hodkinson, H M and Hodkinson, I (1980). 'The influence of route
of admission on outcome in the geriatric patient'. Age and Ageing, 9, 229-234.
Hodkinson, H M (1985). Personal communication. Khan, R L, Goldfarb, A I and Pollack, I E (1960). 'The relationships
of mental and physical status in the institutionalised aged person', American Journal of Psychology, 117, 120-124.
Kane, R A and Kane, R L (1981). 'Assessing the elderly', Lexington Books, USA.
Oddy, R (1987). 'Promoting mobility in patients with dementia, some suggested strategies for physiotherapists', Physiotherapy Practice,
Rubenstein, L, Schairer, C, Wieland, G and Kane, R (1984). 'Systematic biases in functional status assessment of elderly adults: Effects of different data sources', Journal of Gerontology,
Squires, A J (1986). 'Physiotherapy assessment of the elderly patient', Physiotherapy, 72, 12, 617-620.
Stewart, C P U (1981). 'Mental status questionnaire, activities of daily living and discharge category in elderly patients undergoing rehabilitation', Journal of Clinical and Experimental Gerontology,
3, 18-27.
39, 6, 686-691.
3, 4, 387-389.
ACKNOWLEDGMENTS Bromley Health Authority Information Systems Department for computing the results: Jock Rumgay
for keying in the data; Cecily Partridge for help with the mobility index; ACPSIEP members and patients who took part in the project: ACPSIEP for funding the printing of the 'mobility index' forms; and Tina West for typing the manuscript.
In Other Journals Physiotherapy Theory and Practice
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Grip strength as a function of age, height, body weight and Quetelet index. J Balogun, A Akinloye, S Adenola. 111-119
Balance training in 70-year-old women. G Johansson, G Britt Jarnlo.
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121-125
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Clinical research in complementary medicine. F A C Wiegant,
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G Lewith, C Williams. 93-95
99-109
C W Kramers, R Van Wijk. 110-115
Quantitative measurements of spasticity in children with cerebral palsy. R Price, K F Bjornson, J F Lehmann, J F McLaughlin, R M Hays. 585-595
Age-associated changes in the syrnptomatology of Guillain-Barre syndrome in children. Y Sakakihara, S Kamoshita. 611-616
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Accuracy and reliability of measurements. R Bohannon, R Waldron.
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Variation in the provision of cardiothoracic physiotherapy in Australian hospitals. G Ntoumenopolous, K Greenwood. 29- 38
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J Balogun, E Adeniyi, E Akala. 105-112.
Physiotherapy Canada 1997, vol 42, no I, January/February Peak torque to body weight ratios in older adults: A re-examination.
M Brown, A Delitto. 7-11 A retrospective survey of music-related musculoskeletal problems
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Goal-setting in physical therapy practice. C Cott, E Finch. 19-22 Compliance to and effects of a home strengthening exercise
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Physiotherapy, December 1991, vol77, no 72 795