Physical performance tests, self-reported outcomes, and accidental falls before and after total knee arthroplasty: An exploratory study. (August 2013)

• Record Type: Journal Article
• Authors: Swinkels, Annette; Allain, Theresa J.
• Is Part Of: Physiotherapy theory and practice. Volume 29:Number 6(2013:Aug.)
• Page Start: 432
• Page End: 442
• Publication Date: 2013-08
• Subjects: Physical therapy -- Periodicals; 615.82
• DOI: 10.3109/09593985.2012.755590
• Languages: English
• ISSNs: 0959-3985

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <p>This longitudinal, observational study explored the relationship between physical performance tests, self-reported outcomes, and accidental falling, before and after total knee arthroplasty (TKA). Thirty-seven patients were randomly selected from a larger study of falling before and after surgery conducted at a UK National Health Service Orthopaedic Unit<bold>.</bold> Physical performance tests were the Berg Balance Score (BBS), Timed Up and Go (TUG), and Hand Grip Strength (HGS). Self-reported outcomes incorporated the Western Ontario and McMaster's Osteoarthritis Index (WOMAC), Activities Balance Confidence Scale (ABC-UK), Geriatric Depression Scale (GDS), and accidental falls. Paired pre- and postoperative data were available on 22 patients. A total of 22.7% patients fell before and after TKA. Postoperative improvement in BBS and TUG was found in 41% and 50% of patients, respectively, HGS did not change. BBS showed a consistent moderate-to-strong association with other physical tests both before and after surgery; TUG (<italic>r</italic><sub><italic>s</italic></sub> −0.76; <italic>r</italic><sub><italic>s</italic></sub> −0.90), maximal HGS (<italic>r</italic> 0.49; <italic>r</italic> 0<italic>.</italic>48<italic>), </italic> and self-report measures; ABC-UK (<italic>r</italic> 0.52; <italic>r</italic> 0.74), WOMAC stiffness (<italic>r</italic> −0.53; <italic>r</italic> −0.48), and WOMAC function (<italic>r</italic> −0.56; <italic>r</italic> −0.45). Although self-report questionnaires are an efficient, cost-effective approach to outcome assessment in TKA, there is a growing case for inclusion of physical performance tests. The Berg Balance Score may be a useful addition to outcome assessment in patients with TKA.</p> </abstract>