Person-reported outcome measures for goal achievement or functional change in people undergoing rehabilitation with allied health professionals: a rapid evidence map and synthesis

Allied Health Professionals (AHPs) play a key role in delivering rehabilitation across Wales, but service-access and evaluation vary. To improve consistency, a national framework is being developed to measure how much care is delivered, its quality, and its impact on quality of life, wellbeing, agency, activity and participation. This review focuses on identifying the best person-reported outcome measures (PROMs) for tracking goal achievement and functional improvement. The review included evidence available up until August 2025. 101 systematic reviews, covering 19 free-of-charge PROMs with evidence of content validity, were included in the rapid evidence map (REM). The REM provides a description of the PROM’s purpose, ease of use, relevance to AHP rehabilitation, and the number of reviews that evaluated the quality and performance of the PROM - and in which populations. It does not summarise the findings. Based on the REM, eight PROMs were selected for detailed analysis. 47 reviews examined the measurement properties of these eight PROMs. The approximate time taken to complete the PROM was five minutes or less for 14 PROMs. Two PROMs had potential administration times of 60 minutes or more. The number of questions included in the PROMs ranged from one to 135. Most systematic reviews included people with general (or mixed) conditions. Many reviews in the REM included populations with neurological and neuromuscular conditions, and musculoskeletal and pain conditions. Few reviews focusing on other specific conditions were identified. Content validity, construct validity and test-retest reliability were the only measurement properties that were investigated in systematic reviews for all 19 PROMs. Face validity was reported for the fewest number of PROMs. Seven PROMs had reviews investigating all measurement properties. The eight PROMs prioritised for detailed analysis were the Goal Attainment Scale (GAS), Lawton-Brody Instrumental Activities of Daily Living (IADL), International Classification of Functioning, Disability and Health Measure of Participation and Activities Screener (IMPACT-S), Keele Assessment of Participation (KAP), Patient-Specific Functional Scale (PSFS), Reintegration to Normal Living Index (RLI/RLNI), Utrecht Scale for Evaluation of Rehabilitation – Participation (USER-P) and World Health Organization Disability Assessment Schedule version 2.0 - 12 items (WHODAS 2 -12). Most of the systematic reviews aimed to evaluate the quality and performance of the PROMs in a general population receiving rehabilitation. For each PROM, an overall quality rating was assigned for each measurement property. Four of the PROMs (GAS, IADL, IMPACT-S and RLI/RNLI) were rated as sufficient for three or more measurement properties in the general conditions category, and one PROM (PSFS) was rated as sufficient for two measurement properties in this category. GAS, IADL, IMPACT-S, PSFS, RLI/RNLI and WHODAS 2-12 also had some sufficient measurement properties in the more specific population categories. All the ratings of KAP and USER-P scales were either indeterminate, inconsistent or insufficient. GAS, IADL and RNI/RNLI were the only PROMs identified as having sufficient content validity, considered the most important measurement property as it ensures the outcome measurement instrument accurately and completely captures what it is intended to measure before other types of validity or reliability are assessed. Only GAS and PSFS had evidence of good responsiveness, a crucial property to detect change in function. We also summarise the evidence gaps in this review. While some PROMs (GAS, IADL, IMPACT-S, PSFS, RLI/RNLI and WHODAS 2-12) show promise for the planned shortlist of measures suitable for assessing rehabilitation services across Wales, the choice of PROM will also depend on other things, such as feasibility, population fit and practical considerations.