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

dc.contributor.author

Scott, Elizabeth J

dc.contributor.author

Willey, Michael C

dc.contributor.author

Mercado, Arthur

dc.contributor.author

Davison, John

dc.contributor.author

Wilken, Jason M

dc.date.accessioned

2024-05-14T02:15:35Z

dc.date.available

2024-05-14T02:15:35Z

dc.date.issued

2020-02

dc.description.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.
dc.identifier

10.1177_2325967120903290

dc.identifier.issn

2325-9671

dc.identifier.issn

2325-9671

dc.identifier.uri

https://hdl.handle.net/10161/30701

dc.language

eng

dc.publisher

SAGE Publications

dc.relation.ispartof

Orthopaedic journal of sports medicine

dc.relation.isversionof

10.1177/2325967120903290

dc.rights.uri

https://creativecommons.org/licenses/by-nc/4.0

dc.subject

clinical outcomes

dc.subject

dysplasia

dc.subject

hip

dc.subject

hip arthroscopy

dc.subject

performance measures

dc.title

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

dc.type

Journal article

duke.contributor.orcid

Scott, Elizabeth J|0000-0003-1238-1931

pubs.begin-page

2325967120903290

pubs.issue

2

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Staff

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Orthopaedic Surgery

pubs.publication-status

Published

pubs.volume

8

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