scholarly journals The A-test: Assessment of functional recovery during early rehabilitation of patients in an orthopedic ward - content, criterion and construct validity

2014 ◽  
Vol 71 (8) ◽  
pp. 715-722 ◽  
Author(s):  
Aleksandra Vukomanovic ◽  
Aleksandar Djurovic ◽  
Zoran Popovic ◽  
Vesna Pejovic
Keyword(s):  
Hip Fracture ◽  
Construct Validity ◽  
Functional Recovery ◽  
Test Score ◽  
Weight Bearing ◽  
Hip Osteoarthritis ◽  
Early Rehabilitation ◽  
Ordinal Scale ◽  
Test Results ◽  
Orthopedic Ward

Background/Aim. The A-test was designed for assessment of functional recovery during early rehabilitation of patients in an orthopedic ward. This performance-based test consists of 10 items for assessing basic activities by a six level ordinal scale (0-5). Total scores can range from 0 to 50, i.e. from inability to perform any activity despite the help of therapists to complete independence and safety in performing all activities. The aim of this study was to examine the A-test validity. Methods. This prospective study was conducted in an orthopedic ward and included 120 patients [60 patients with hip osteoarthritis that underwent arthroplasty and 60 surgically treated patients with hip fracture (HF)] during early inpatient rehabilitation (1st-5th day). Validity was examined through 3 aspects: content validity - floor and ceiling effect, range, skewness; criterion validity - concurrent validity [correlation with the University of Iowa Level of Assistance Scale (ILAS) for patients with hip osteoarthritis, and with the Cumulated Ambulation Score (CAS) for patients with HF, Spearman rank correlation] and predictive validity [the New Mobility Score (NMS) 4 weeks after surgery, Mann-Whitney U test]; construct validity - 4 hypotheses: 1) on the fifth day of rehabilitation in patients underwent arthroplasty due to hip osteoarthritis, the A-test results will strongly correlate with those of ILAS, while the correlation with the Harris hip score will be less strong; 2) in patients with HF, the A-test results will be significantly better in those with allowed weight bearing as compared to patients whom weight bearing is not allowed while walking; 3) results of the A-test will be significantly better in patients with hip osetoarthritis than in those with HF; 4) the A-test results will be significantly better in patients younger than 65 years than in those aged 65 years and older. Results. The obtained results were: low floor (1%) and ceiling (2%) effect, range 0-50, skewness 0.57, strong correlation with ILAS for the patients with hip osteoarthritis (r = -0.97, p = 0.000) and with CAS for the patients with hip fracture (r = 0.91, p = 0.000) The patients with the A-test score 35 and more on the fifth day of rehabilitation (n = 46, Md = 4) had significantly higher NMS rank 4 weeks after surgery than the patients with the A-test score less than 35 (n = 59, Md = 2), (U = 379, z = -6.47, p = 0.000, r = 0.63). All 4 hypotheses were confirmed. Conclusion. The A-test is simple and valid instrument for everyday evaluation of pace and degree of functional recovery during early rehabilitation of patients surgically treated in an orthopedic ward.

scholarly journals The A-test: Reliability of functional recovery assessment during early rehabilitation of patients in an orthopedic ward

2014 ◽  
Vol 71 (7) ◽  
pp. 639-645
Author(s):  
Aleksandra Vukomanovic ◽  
Aleksandar Djurovic ◽  
Zoran Popovic ◽  
Dejan Ilic
Keyword(s):  
Hip Fracture ◽  
Internal Consistency ◽  
Functional Recovery ◽  
Hip Osteoarthritis ◽  
Kappa Coefficient ◽  
Early Rehabilitation ◽  
Coefficient Alpha ◽  
Interobserver Reproducibility ◽  
Consistency Of The Test ◽  
Orthopedic Ward

Background/Aim. There are few tests for evaluation of functional abilities of patients surgically treated for hip fractures or osteoarthritis during early rehabilition period. The aim of this study was to investigate reliability (interobserver reproducibility and internal consistency) of the A-test, an original test for functional recovery evaluation during early rehabilitation of patients in an orthopedic ward. Methods. The investigation included 105 patients (55 patients with hip osteoarthritis that underwent arthroplasty and 50 surgically treated patients with hip fracture). It was conducted in an orthopedic ward during early inpatient rehabilitation (from 1st to 5th day). For their functional recovery evaluation during early rehabilitation we used the A-test, a performance-based test with 10 items for assessing basic activities by six level ordinal scale (0-5). For internal consistency of the test the Cronbach coefficient alpha was calculated for the A-test results collected during early rehabilitation for all patients (105 patients x 5 days = 525 measures) and separately for the results of patients with hip osteoarthritis (275 measures) and hip fracture (250 measures). Values of this coefficient > 0.7 imply good internal consistency of the test. Interobserver reproducibility was estimated as follows: two physiotherapists together conducted physical therapy with the patients, and then, separately, rated the performance of each activity from the test (78 measures). The agreement between their estimations was expressed by the linear weighted kappa coefficient (for very good agreement values of kappa coefficient have to be in the range 0.81-1). Results. The Cronbach coefficient alpha was 0.98 (the results of all the patients and the results of the patients with hip osteoarthritis) and 0.97 (the results of the patients with hip fracture). The values of kappa coefficient were in the range 0.81-0.92 for all items. Conclusion. The A-test is a reliable instrument for everyday evaluation of functional recovery during early rehabilitation of patients surgically treated in an orthopedic ward.

Item Context and /s/ Phone Articulation Test Results

1972 ◽  
Vol 15 (4) ◽  
pp. 852-860 ◽  
Author(s):  
Zoe Zehel ◽  
Ralph L. Shelton ◽  
William B. Arndt ◽  
Virginia Wright ◽  
Mary Elbert
Keyword(s):  
Test Score ◽  
Sound Production ◽  
Broad Context ◽  
Test Results ◽  
Production Task ◽  
Test Result

Fourteen children who misarticulated some phones of the /s/ phoneme were tape recorded articulating several lists of items involving /s/. The lists included the Mc-Donald Deep Test for /s/, three lists similar to McDonald’s but altered in broad context, and an /s/ sound production task. Scores from lists were correlated, compared for differences in means, or both. Item sets determined by immediate context were also compared for differences between means. All lists were found to be significantly correlated. The comparison of means indicated that both broad and immediate context were related to test result. The estimated “omega square” statistic was used to evaluate the percentage of test score variance attributable to context.

scholarly journals Identification of hip fracture patients at risk for postoperative mobilisation complications via handgrip strength assessment

2021 ◽  
Author(s):  
Johannes Gleich ◽  
Daniel Pfeufer ◽  
Alexander M. Keppler ◽  
Stefan Mehaffey ◽  
Julian Fürmetz ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Gait Speed ◽  
Handgrip Strength ◽  
Weight Bearing ◽  
Proximal Femur Fracture ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Strength Assessment ◽  
Positive Correlation ◽  
Prospective Study Design

Abstract Introduction Treatment of older adult hip fracture patients can be challenging and requires early postoperative mobilisation to prevent complications. Simple clinical tools to predict mobilisation/weight-bearing difficulties after hip fracture surgery are scarcely available and analysis of handgrip strength could be a feasible approach. In the present study, we hypothesised that patients with reduced handgrip strength show incapability to follow postoperative weight-bearing instructions. Materials and methods Eighty-four patients aged ≥ 65 years with a proximal femur fracture (trochanteric, n = 45 or femoral neck, n = 39), who were admitted to a certified orthogeriatric center, were consecutively enrolled in a prospective study design. Five days after surgery (intramedullary nailing or arthroplasty), a standardised assessment of handgrip strength and a gait analysis (via insole forcesensors) was performed. Results Handgrip strength showed positive correlation with average peak force during gait on the affected limb (0.259), postoperative Parker Mobility Score (0.287) and Barthel Index (0.306). Only slight positive correlation was observed with gait speed (0.157). These results were congruent with multivariate regression analysis. Conclusion Assessment of handgrip strength is a simple and reliable tool for early prediction of postoperative mobilisation complications like the inability to follow weight-bearing instructions in older hip fracture patients. Follow-up studies should evaluate if these findings also match with other fracture types and result in personalised adjustment of current aftercare patterns. In addition, efforts should be made to combine objectively collected data as handgrip strength or gait speed in a prediction model for long-term outcome of orthogeriatric patients.

Delirium Is Independently Associated with Poor Functional Recovery After Hip Fracture

2000 ◽  
Vol 48 (6) ◽  
pp. 618-624 ◽  
Author(s):  
Edward R. Marcantonio ◽  
Jonathan M. Flacker ◽  
Mary Michaels ◽  
Neil M. Resnick
Keyword(s):  
Hip Fracture ◽  
Functional Recovery

The approach to patients with cognitive impairment and hip fracture: the role of orthogeriatric care

2014 ◽  
Vol 24 (3) ◽  
pp. 219-227 ◽  
Author(s):  
Francisco J Tarazona-Santabalbina ◽  
Juan R Doménech-Pascual ◽  
Ángel Belenguer-Varea A ◽  
Eduardo Rovira Daudi
Keyword(s):  
Cognitive Impairment ◽  
Hip Fracture ◽  
Functional Recovery ◽  
Functional Outcomes ◽  
Older Patients ◽  
Future Research ◽  
Research Perspectives ◽  
Increased Risk ◽  
Risk Of Falls

SummaryHip fracture is very common among older patients, who are characterized by increased co-morbidities, including cognitive impairment. These patients have an increased risk of falls and fractures, poorer functional recovery and lower survival both in hospital and 12 months after discharge. We review the survival and functional outcomes of older patients with cognitive impairment and hip fracture managed in orthogeriatric units, and highlight the gaps in our knowledge of the efficacy and efficiency of specific orthogeriatric programmes for such patients and the future research perspectives in this field.

scholarly journals Predictive Model of Gait Recovery at One Month after Hip Fracture from a National Cohort of 25,607 Patients: The Hip Fracture Prognosis (HF-Prognosis) Tool

2021 ◽  
Vol 18 (7) ◽  
pp. 3809
Author(s):  
Cristina González de Villaumbrosia ◽  
Pilar Sáez López ◽  
Isaac Martín de Diego ◽  
Carmen Lancho Martín ◽  
Marina Cuesta Santa Teresa ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Predictive Model ◽  
Weight Bearing ◽  
Individual Characteristics ◽  
Predicted Probability ◽  
National Cohort ◽  
Probability Threshold ◽  
Anesthetic Risk ◽  
Validation Set ◽  
Operative Delay

The aim of this study was to develop a predictive model of gait recovery after hip fracture. Data was obtained from a sample of 25,607 patients included in the Spanish National Hip Fracture Registry from 2017 to 2019. The primary outcome was recovery of the baseline level of ambulatory capacity. A logistic regression model was developed using 40% of the sample and the model was validated in the remaining 60% of the sample. The predictors introduced in the model were: age, prefracture gait independence, cognitive impairment, anesthetic risk, fracture type, operative delay, early postoperative mobilization, weight bearing, presence of pressure ulcers and destination at discharge. Five groups of patients or clusters were identified by their predicted probability of recovery, including the most common features of each. A probability threshold of 0.706 in the training set led to an accuracy of the model of 0.64 in the validation set. We present an acceptably accurate predictive model of gait recovery after hip fracture based on the patients’ individual characteristics. This model could aid clinicians to better target programs and interventions in this population.

scholarly journals Evaluation of Functional Recovery by Motor Functional Independence Measure Test of Elderly After Hip Fracture in Serbia

2014 ◽  
Vol 27 (1) ◽  
pp. 88 ◽  
Author(s):  
Natasa Radosavljevic ◽  
Dejan Nikolic ◽  
Milica Lazovic ◽  
Zoran Radosavljevic ◽  
Aleksandar Jeremic
Keyword(s):  
Hip Fracture ◽  
Functional Recovery ◽  
Age Groups ◽  
Functional Independence Measure ◽  
Severity Index ◽  
Functional Independence ◽  
Post Discharge ◽  
Third Age ◽  
Period 2 ◽  
Group 2

<p class="p0" style="margin-bottom: 0pt; margin-top: 0pt; text-align: justify; line-height: 200%;"><span style="mso-spacerun: 'yes'; font-size: 12.0000pt; font-family: 'Times New Roman'; background: #ffffff; mso-shading: #ffffff;"><strong>Introduction:</strong> The aim of the study was to evaluate motor functional status measured by motor Functional Independence Measure (mFIM) test in population above 65 years of age after the hip fracture.<br /><strong>Material and Methods:</strong> We evaluated 203 patients after hip fracture by mFIM test on 3 occasions: at admission (Period-1), at discharge (Period-2) and 3 months after discharge (Period-3); 3 age groups: Group65-74, Group75-84 and Group85-up and 2 groups concerning Severity Index (SI): group 0-1.99 (SI1) and group ≥ 2 (SI2).<br /><strong>Results:</strong> In same SI group there is significant increase in mFIM values for Period-2 and Period-3 for both genders and in first two age groups, while for those above 85 years of age with higher SI we found non-significant change in mFIM values between discharge and 3 months post discharge period.<br /><strong>Discussion: </strong>The most significant improvement is obtained for women in first and third age groups and with higher SI.<br /><strong>Conclusion:</strong> Gender is not significant predictor for motor functional recovery measured by mFIM test in patients with hip fracture, although the admittance mFIM is a good indicator for mFIM capacity recovery in women of certain age groups (first and third age groups).</span></p>

Effect of rehabilitation site on functional recovery after hip fracture

2005 ◽  
Vol 86 (3) ◽  
pp. 367-372 ◽  
Author(s):  
Michael C. Munin ◽  
Karen Seligman ◽  
Mary Amanda Dew ◽  
Tanya Quear ◽  
Elizabeth R. Skidmore ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Functional Recovery

Frailty defined by 19 items as a predictor of short-term functional recovery in patients with hip fracture

Injury ◽  
2019 ◽  
Vol 50 (12) ◽  
pp. 2272-2276 ◽  
Author(s):  
Tatsuro Inoue ◽  
Shogo Misu ◽  
Toshiaki Tanaka ◽  
Tetsuya Kakehi ◽  
Masayoshi Kakiuchi ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Functional Recovery ◽  
Short Term
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