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No correlation between symmetry based performance measures and patient related outcome prior to and after total knee arthroplasty

  • Standardized outcome measures are crucial for the evaluation of different treatment and rehabilitation regimes in patients after total knee arthroplasty (TKA). Performance-based measures are necessary to capture different aspects of physical function. High reliability and agreement of five performance-based measures were hypothesized to differentiate between measurement error and change in test performance. Secondary outcomes are the correlation of performance-based measurements to KSS and WOMAC prior to surgery (baseline) and 10 weeks thereafter (t3). Methods The test–retest reliabilities and agreements of the 1-m walk test, the stair-climbing test, the timed-up-and-go test, the weight-balanced-chair-rising test and the isometric maximum knee extension force in patients undergoing total knee replacements were studied. The intraclass correlation coefficient was calculated and a Bland–Altman analysis performed. The weight-balanced-chair-rising test showed a symmetry at baseline = 0.77, 5 ± 1 days after surgery (t1) = 0.50, 9 ± 1 daysStandardized outcome measures are crucial for the evaluation of different treatment and rehabilitation regimes in patients after total knee arthroplasty (TKA). Performance-based measures are necessary to capture different aspects of physical function. High reliability and agreement of five performance-based measures were hypothesized to differentiate between measurement error and change in test performance. Secondary outcomes are the correlation of performance-based measurements to KSS and WOMAC prior to surgery (baseline) and 10 weeks thereafter (t3). Methods The test–retest reliabilities and agreements of the 1-m walk test, the stair-climbing test, the timed-up-and-go test, the weight-balanced-chair-rising test and the isometric maximum knee extension force in patients undergoing total knee replacements were studied. The intraclass correlation coefficient was calculated and a Bland–Altman analysis performed. The weight-balanced-chair-rising test showed a symmetry at baseline = 0.77, 5 ± 1 days after surgery (t1) = 0.50, 9 ± 1 days (t2)= 0.59 and (t3)= 0.80. All performance tests showed high intraclass correlation coefficients (ICC= 0.81–0.99). The 10-m walk test, stair climbing test, and the timed-up-and-go test showed high agreement in the Bland–Altman analysis. The Bland–Altman analysis for the weight-balanced-chair-rising test and isometric knee extension force indicated high agreement at 5 and 9 days postoperatively, but the relative measurement error increased pre- and 10 weeks postoperatively. In conclusion, symmetry, as an important outcome after TKA, is a reliable and rather unique item that should unquestionably be added to established measurements like walking tests or survey-based function assessment. The implementation of standardized performance-based measures to assess physical function in rehabilitation procedures will help to improve the more objectively based assessment of different rehabilitation protocols.show moreshow less

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Metadaten
Author: Robert PrillORCiDGND, Roland Becker, Robert SchulzORCiD, Sven MichelGND, Hagen Hommel
DOI:https://doi.org/10.1007/s00167-021-06570-3
ISSN:1433-7347
Title of the source (English):Knee surgery, sports traumatology, arthroscopy
Document Type:Scientific journal article peer-reviewed
Language:English
Year of publication:2021
Tag:Functional tests; Osteoarthritis; Outcome assessment; Outcome set; Total knee arthroplasty; Total knee replacement
Volume/Year:Vol. 30 (2022)
Issue number:9
First Page:3155
Last Page:3161
Faculty/Chair:Fakultät 4 Humanwissenschaften (bis 2023 Soziale Arbeit, Gesundheit und Musik) / FG Therapiewissenschaften II
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