Assessment of Disability Related to Hip Dysplasia Using Objective Measures of Physical Performance.

Loading...
Thumbnail Image

Date

2020-02

Journal Title

Journal ISSN

Volume Title

Repository Usage Stats

5
views
7
downloads

Citation Stats

Abstract

Background

Lower extremity physical performance measures (PPMs), which can objectively quantify functional ability, are an attractive adjuvant to patient-reported outcome (PRO) instruments. However, few tests have been validated for use in hip instability.

Purpose

To evaluate 4 different PPMs for their ability to differentiate between young adults with hip dysplasia indicated for treatment with periacetabular osteotomy (PAO) and asymptomatic controls and to test inter- and intratest reliability and relationship with popular hip PRO instruments.

Study design

Cohort study (diagnosis); Level of evidence, 2.

Methods

A total of 24 symptomatic patients aged 15 to 39 years (100% female) with hip dysplasia (lateral center-edge angle <25°) indicated for treatment with PAO completed the visual analog scale (VAS) for pain, Hip disability and Osteoarthritis Outcome (HOOS) Pain subscale, HOOS Short Version (HOOS PS), International Hip Outcome Tool Short Version (iHOT-12), modified Harris Hip Score (mHHS), Patient Reported Outcome Measurement Information System (PROMIS) physical function (PF) and pain interference (PI), and 4 physical function tests: (1) self-selected walking speed (SSWS), sit-to-stand 5 times (STS5), (3) 4-square step test (FSST), and (4) timed stair ascent (TSA). A further 21 young, asymptomatic adults aged 18 to 39 years (91% female) also underwent testing. Between-group comparisons were made with unpaired t test with Bonferroni-Holm correction. Inter- and intrarater reliability was assessed in 38 participants by repeating PPMs at a second visit and using 2 raters. Spearman rank correlation coefficients were used to determine associations between PPMs and PRO instruments.

Results

Significant differences between patients with hip dysplasia and controls were observed for all PRO instruments (HOOS Pain, 47.8 vs 99.2; HOOS PS, 61.9 vs 99.2; iHOT-12, 32.2 vs 99.2; mHHS, 54.5 vs 90.6; PROMIS PF, 41.4 vs 65.6; and PROMIS PI, 62.0 vs 39.1 [all P < .001]), and all PPMs (SSWS, 1.21 vs 1.53 m/s; STS5, 10.85 vs 5.95 s; FSST, 6.59 vs 4.03 s [all P < .001]; and TSA, 4.58 vs 3.29 s [P = .002]). All 4 PPMs demonstrated excellent intra- and intertest reliability (intraclass correlation coefficient, 0.83-0.99). STS5, FSST, and TSA were correlated highly (r > 0.5) with physical function PRO instruments, including PROMIS PF, mHHS, and iHOT-12.

Conclusion

Patients with symptomatic hip dysplasia demonstrated significant impairment on functional testing compared with asymptomatic controls, and performance measure testing demonstrated excellent test-retest reliability. Timed stair ascent and sit-to-stand testing in particular were correlated strongly with physical function PRO instruments. PPMs may be a viable and well-received adjuvant to PRO instrument administration for patients with nonarthritic hip conditions, and investigation of the ability of PPMs to assess surgical outcomes for hip dysplasia is warranted.

Department

Description

Provenance

Citation

Published Version (Please cite this version)

10.1177/2325967120903290

Publication Info

Scott, Elizabeth J, Michael C Willey, Arthur Mercado, John Davison and Jason M Wilken (2020). Assessment of Disability Related to Hip Dysplasia Using Objective Measures of Physical Performance. Orthopaedic journal of sports medicine, 8(2). p. 2325967120903290. 10.1177/2325967120903290 Retrieved from https://hdl.handle.net/10161/30701.

This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.

Scholars@Duke

Scott

Elizabeth Joy Scott

Assistant Professor of Orthopaedic Surgery

Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.