ABSTRACT
STUDY DESIGN: Single-group, repeated-measures study. OBJECTIVE: To estimate the test-retest reliability, construct validity, and responsiveness of the Lower Extremity Functional Scale (LEFS) on inpatients attending an orthopaedic rehabilitation ward. BACKGROUND: The LEFS has acceptable validity on outpatients in assessing functional mobility, but it has not been tested for use on an inpatient orthopaedic ward. METHODS AND MEASURES: Inpatients in an orthopaedic ward (n = 142) completed the 20-item, self-report LEFS on admission, 7 to 10 days after admission, and on discharge. To test reliability, 24 patients had the LEFS repeated 1 day after the admission test, and the intraclass correlation (ICC) and the standard error of measurement (SEM) were calculated. Change scores of the LEFS were evaluated against patients' and therapists' rating of improvement, and change scores of comparison measures that included pain, functional performance, and the composite index created from scores of these comparison measures. The standardized response mean (SRM) of the LEFS was also computed. RESULTS: The ICC of the LEFS was 0.88, and the SEM was 4 LEFS points (LEFS score range, 0-80). The change in LEFS correlated with changes of comparison measures in the same direction of improvement. Patients rated as improved by both themselves and their therapists had significantly larger change in LEFS scores than subjects rated as no change. The SRM of the LEFS from admission to discharge was 1.76 on patients rated as improved. CONCLUSION: The LEFS is reliable and valid to assess group and individual change, and has large responsiveness. The LEFS and the comparison measures likely assess different constructs.
Subject(s)
Inpatients , Lower Extremity , Musculoskeletal Diseases/rehabilitation , Outcome Assessment, Health Care , Physical Therapy Modalities/standards , Adolescent , Adult , Disability Evaluation , Female , Humans , Male , Middle Aged , Musculoskeletal Diseases/physiopathology , Recovery of Function , Reproducibility of Results , Statistics, NonparametricABSTRACT
STUDY DESIGN: Single-group repeated-measures study. OBJECTIVE: To examine the test-retest reliability of the timed up and go (TUG) test and its validity for measuring change and predicting length of stay (LOS) on an inpatient orthopaedic rehabilitation ward. BACKGROUND: The TUG test is used to measure functional mobility of persons with musculoskeletal conditions but it has not been thoroughly tested for use in an inpatient orthopaedic rehabilitation ward. METHODS AND MEASURES: The TUG test was administered to 142 patients on admission to an orthopaedic rehabilitation ward 7 to 10 days after admission and on discharge. To test reliability, 24 subjects had these tests repeated 1 day after admission, and the intraclass correlation (ICC) and standard error of measurement (SEM) were calculated. Change scores of the TUG test were evaluated against change scores in pain and function, and the rating of improvement of the patient and therapist. The standardized response mean (SRM) was also calculated. A regression analysis was performed to determine whether the admission TUG test score could predict LOS. RESULTS: The ICC of the TUG test was 0.80 and the SEM was 10.2 seconds. The change in TUG test scores correlated with the changes in pain (r = 0.21, P<.01) and function (r = -0.23, P<.01), and resulted in an SRM of 0.89 for subjects rated as improved. The admission TUG test scores accounted for only 3.4% of the variance in inpatient LOS. CONCLUSION: The TUG test is reliable and valid to assess group change of inpatients on an orthopaedic rehabilitation ward but is not a good predictor of LOS. LEVEL OF EVIDENCE: Prognosis, level 1b.
