Objective evaluation is defined as highly reliable evaluation. Even if the measurement method serves the purpose, the possibility exists that “a difference” to be found is covered by large errors. This report reviews the methods for obtaining Intra-rater reliability and Inter-rater reliability using Intraclass correlation coefficient (ICC).

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Appropriate functional assessment is indispensable for physical therapy intervention, which consequently results in effective and high-quality treatment for each patient. It is, however, true that the effectiveness of physical therapy is not fully confirmed in various diseases, and the assessment method is now expected to be developed by a physical therapist. This review describes the latest topics about the functional assessment for Disablement and Outcomes Measures, and also introduces their problems to be solved.

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Observation and analysis of neurological symptoms and signs in clinical neurology are aimed at diagnosing and curing a causative disease from the pathology-oriented approach. Rehabilitation medicine including physical therapy, on the other hand, lays stress on the function-oriented approach. There is no doubt that rehabilitation is essential to the treatment of patients with neurological disorders, but functional diagnosis by clinical neurology is also of prime importance. Even in a single symptom of motor paresis, the more the relevant data of neurological symptom is collected, the more precisely the affected region can be identified and the more accurately the lesion be analyzed. These allow us to evaluate precisely the prediction of functional disorder, and to select more effective therapeutic methods for each patient. In the present clinical context, no serious consideration is taken to a cooperation between functional diagnosis of clinical neurology and functional evaluation of rehabilitation; that is, the present medical service for the patients with neurological disorders is considered insufficient.

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The basic concept of Geofferey Maitland, one of the researchers who have systematized the evaluation of orthopedic physical therapy, is introduced here. The concept is characterized by the two examinations; subjective examination of clinical symptoms by interviewing a patient, and objective examination of patient's clinical signs by the scientific method. The method is undertaken in the following order; subjective examination, planning of objective examination, objective examination, treatment plan, treatment, and re-evaluation. The method will enable us to grasp and tackle equivocal complaints of the patients.

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This review describes first the definition of aging and several theories about aging. Characteristics of functional deterioration with aging are then reviewed from the viewpoints of morphology, kinesiology, respiratory and cardiovascular system, and nervous and sensory system. It is suggested that the aged should be evaluated individually, not by comparing with the adults, and that the analysis of their obstructing factors is important for complying with their individual requests.

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Clinical symptoms of motor impairment resulting from higher brain dysfunction are reviewed here by classifying them into apraxia and other impairments than apraxia. Then, idetional apraxia and Pusher sign are further described. Analysis of error responses is of importance in the evaluation of idetional apraxia, and description of motor pattern as well as the analysis of the severity is essential in the evaluation of Pusher sign.

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Although diagnostic methods for unilateral neglect have been reported, we have found that patients' physical performance examined by those methods is not always reflected by their all neglect phenomena. In case, there is a discrepancy of their abilities in daily life and the test situation. We should therefore observe carefully patients' behavior both in daily life and training. Unilateral neglect is possibly influenced by various modalities such as visual input, electrical stimulation, and trunk rotation, and patients will exhibit different performance by a different modality, even in the same examination. It is therefore necessary for physical therapists to evaluate and investigate the most effective modality for improving the neglect.

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If we, physical therapists, try to administer the treatment on the basis of an informed consent, not only to evaluate a patient in a more scientific way, we should always prepare enough information to logically explain the purpose, final goal, period, and effectiveness of the treatment to the patient. One of the evaluation methods serving the above purpose is a motion analysis with guiding based on the clinical reasoning. In the method, we help patients aware and evaluate their condition by themselves, and we can obtain more data because contact and move with patient. We introduce here the general concept of the evaluation method based on clinical reasoning.

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