The following outcome measures (and weblinks) are OUTCOME MEASURES USEFUL FOR TOTAL JOINT ARTHROPLASTY Measure Arthritis Self- Efficacy Scale What: Self-efficacy (current) Who: Pre-and post arthroplasty How: Paper-based, 20 items rated from 10 100 points. Less than 5 mins to complete Scoring: Higher score = better self efficacy http://patienteducation.stanford.edu/research/searthritis.html Self-Management Behaviours Exercise What: Exercise behaviors Who: Pre & post-arthroplasty (not approp in acute care setting) How: Paper-based, 6 items scored on 5-point scale. Less than 2 mins to complete Scoring: Higher score = more physical activity http://patienteducation.stanford.edu/research/exercise.html Numeric Pain Rating Scale What: Pain intensity (current) How: Multiple options (e.g. paper, sliding scale), 0-10 or 0-100 scale. Less than 2 mins to complete Scoring: Higher score = greater pain intensity http://www.wsib.on.ca/wsib/wsibobj.nsf/lookupfiles/poclei_poc_tools/$file/lei_poc_tools.pdf Pain Visual Numeric Scale What: Pain intensity in affected area (during past 2 weeks) How: Multiple options (paper, on-line), 0-10 scale. Less than 1 min to complete Scoring: Higher score = greater pain intensity http://patienteducation.stanford.edu/research/vnspain.html Lower Extremity Functional Scale (LEFS) What: Functional status (current) Who: Pre & post-arthroplasty (not appropriate in acute care setting) How: Paper-based or on-line, 20-items on a 5-point scale. Less than 5 mins to complete Scoring: Higher score = better function http://www.wsib.on.ca/wsib/wsibobj.nsf/lookupfiles/poclei_poc_tools/$file/lei_poc_tools.pdf 1
Oxford Hip Score (OHS) What: Functional status (past 4 weeks) Who: Pre & post-tha (not appropriate in acute care setting) How: Paper-based on on-line, 12 items, 12-60 point scale. Less than 5 mins to complete Scoring: Original method lower score = better function. Newer method higher score = better function. http://phi.uhce.ox.ac.uk/ox_scores.php Oxford Knee Score (OKS) What: Functional status (past 4 weeks) Who: Pre & post-tka (not appropraite in acute care setting) How: Paper-based on on-line, 12 items, 12-60 point scale. Less than 5 mins to complete Scoring: Original method: lower score = better function. Newer method: higher score = better function. http://phi.uhce.ox.ac.uk/ox_scores.php EuroQOL (EQ-5D) What: Health-related quality of life (HRQoL) (current) How: Multiple options (e.g. paper-based, on-line, phone interview), 5 items using 0-100 rating scale & VAS for overall health. Less than 5 mins to complete Scoring: Lower score = higher HRQoL for 5-items & VAS. Special considerations: Permission required for use. Normative data available for Canada. http://www.euroqol.org/eq-5d/how-to-obtain-eq-5d.html Knee injury & Osteoarthritis Outcome Score (KOOS) What: Pain, stiffness, function & HRQoL sections (during past week) Who: Pre & post TKA (not appropriate for acute care setting) How: Multiple options (e.g. paper-based, on-line), 42 items on 5-point scale. Less than 10 minutes to complete Scoring: Subscale scores converted to 0-100 scale. Higher score = better outcome Special considerations: Contains the WOMAC OA Index 3.0. Includes sports & recreation items for later stages on continuum Has been translated into several languages, http://www.koos.nu/. Select KOOS from left hand side of the web page. Hip injury & Osteoarthritis Outcome Score (HOOS) What: Pain, stiffness, function & HRQoL sections (during past week) Who: Pre & post THA (not appropriate for acute care setting) How: Multiple options (e.g. paper-based, on-line), 40 items on 5-point scale. Less than 10 minutes to complete Scoring: Subscale scores converted to 0-100 scale. Higher score = better outcome Special considerations: Contains the WOMAC OA Index 3.0. Includes sports & recreation items for later stages on continuum Has been translated into several languages, http://www.koos.nu/. Select HOOS from left hand side of the web page. 2
Sit To Stand Test (Also called Repeated Stand Test, Timed Stand Test) What: Lower limb strength (current) Who: Pre & post-arthroplasty (not appropriate for acute care setting) How: 3 options 5 repetitions, 10 repetitions (recorded in secs) or number completed in 30 secs. Less than 2 mins to complete. Scoring: Based on option used. Special considerations: Must use the same straight back chair without arm rests. Normative data available. Full pdf article about Five-Times-Sit-To-Stand test available at http://ptjournal.apta.org/cgi/content/abstract/85/10/1034 Description of number completed in 30 seconds is available at http://www.exrx.net/calculators/seniorchairstand.html Walking Speed (Also called Self- Paced Walk Test, Gait Velocity) What: Walking speed (current) Who: Pre & post-arthroplasty (not appropriate for acute care setting) How: Multiple options including 10 feet, 50 feet, 6 metres & 40 metres, recorded in secs at either self-selected comfortable or fast pace Scoring: lower score = higher performance Special considerations: May also record heart rate, stride length & rating of perceived exertion. A research example of the ten meter walk test used for stroke patients can be found at http://leaps.usc.edu/portals/0/files/misc/clinical_outcome_measures_and_procedures/ten_meter_walk_2009_1_30.pdf A description of a 25 foot walk test used for MS can be found at.. http://www.nationalmssociety.org/for-professionals/researchers/clinical-study-measures/t25-fw/index.aspx 6 Minute Walk Test Variations: 2 minute, 3 minute or 12 minute Walk Tests Timed Up and Go (TUG) Alternate name: Get up and Go What: Functional aerobic capacity (current) except in acute care setting How: Distance walked in 6 minutes (measured in feet); < 10 minutes Scoring: Greater distance = better performance Special considerations: may also record heart rate and/or rating of perceived exertion; Ideally performed in enclosed quiet corridor or indoor track; Normative data available Information and instructions are in Physical Rehabilitation Outcome Measures, 2002 (by Cole, Finch, Gowland, & Mayo) available from the Canadian Physiotherapy Association. What: Risk of falls using balance and basic functional mobility (current) except in acute care setting How: Performance test; Time to rise from chair, walk 3 m, turn around, return to chair and site (measured in seconds); usually 2 minutes Scoring: Lower score = better performance Special considerations: Patient to use current walking aid; Some normative data available; Can be used as a screening tools for falls risk: >/= 13.5 sec = risk for fall in community dwelling frail elders; >/= 30 sec = functional dependence Information and instructions are in Physical Rehabilitation Outcome Measures, 2002 (by Cole, Finch, Gowland, & Mayo) available from the Canadian Physiotherapy Association. 3
Timed Stair Climb What: Many aspects of functional performance (current) Who: All phases of the continuum except in acute care setting How: Time to go up and down 9 stairs (with handrail available) at a safe, comfortable pace (measured in seconds). Usually < 2 minutes Scoring: Lower score = better performance Special considerations: For safety, ensure that the patient does not turn around in the middle of a flight of stairs to descend. Thus, modify the number of steps ascended based upon the available number of steps for the specific flight of steps. Here is a link to a paper with the following objectives: The purposes of this study were to examine the reliability and sensitivity to change of the six minute walk test (6MWT), timed up and go test (TUG), stair measure (ST), and a fast self-paced walk test (SPWT) in patients with hip or knee osteoarthritis (OA) who subsequently underwent total joint arthroplasty. http://www.ncbi.nlm.nih.gov/pmc/articles/pmc549207/pdf/1471-2474-6-3.pdf/?tool=pmcentrez Tinetti Mobility Test What: Complex balance activities (current) except in acute care setting How: 16 items with specific criteria for each; 2 subscales balance and gait; < 15 minutes Scoring: Higher score = worse performance Special considerations: Has been used to predict falls risk.this test takes 10-15 minutes to compete and involves a series of activities that challenge balance. It requires a chair (hard, armless) a stop watch and a 15 m walkway. Instructions are available on the web at http://agrc.ucsf.edu/files/tinetti%20assessmenttool%20(gait%20and%20balance%20test)%20(week%202%20-mobility).pdf Single Leg Balance Alternate name: Single Leg Stance What: Static balance (current) except in acute care setting How: 2 options (eyes open, eyes closed); Ability to stand on 1 leg (shoes off; arms crossed) without nonwb leg touching ground or other leg; Measured in seconds; Usually < 2minutes Scoring: Higher score = better balance An article with normative data for different ages can be found at http://74.125.95.132/search?q=cache%3awc2mtd7edxoj%3awww.geriatricspt.org%2fmembers%2fpubs%2fjournal%2f2007%2fapril %2FJGPTVol30No1springer.pdf+single+leg+stance+test&hl=en&gl=ca 4
Waist Circumference What: Indicator of obesity, risk factor for cardiac disease and diabetes (current) How: Measure of distance around the abdomen at a specific point usually at the level of the navel; < 2 minutes Scoring: Higher score = greater risk Special considerations: BMI is a measure of total body fat & waist circumference is a measure of abdominal fat. http://www.hc-sc.gc.ca/fn-an/nutrition/weights-poids/guide-ld-adult/weight_book-livres_des_poids-14-eng.php BMI What: Indicator of total body fat (current) How: Height to nearest centimeter, weight to nearest kilogram; calculators (gender specific) available online; < 2 minutes Scoring: BMI > 25 indicates patient is overweight Special considerations: Both waist circumference & BMI may have limitations for specific ethnic groups http://www.bcguidelines.ca/gpac/pdf/oa_bmi.pdf A useful website that enables patients to complete online many of the outcome measures described above (and provides a final score) is http://orthoscores.com/ Developed by: The Provincial Rehab Advisory Group Subcommittee on Outcome Measures May 2010 5