This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowReprints and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Jaglal, S.
Right arrow Articles by Schatzker, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Jaglal, S.
Right arrow Articles by Schatzker, J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Technorati  
What's this?
The Journal of Bone and Joint Surgery 82:955 (2000)
© 2000 The Journal of Bone and Joint Surgery, Inc.

Reliability, Validity, and Responsiveness of the Lower Extremity Measure for Patients with a Hip Fracture*

Susan Jaglal, Ph.D.{dagger}, Zubair Lakhani, B.Sc.{dagger} and Joseph Schatzker, M.D., F.R.C.S.(C){dagger}

Investigation performed at Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada
*No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. Funds were received in total or partial support of the research or clinical study presented in this article. The funding source was a grant from the Sunnybrook Trust Foundation.
{dagger}M. E. Müller Program in Research, Sunnybrook and Women's College Health Sciences Centre, 2075 Bayview Avenue, Suite D-514, Toronto, Ontario M4N 3M5, Canada. E-mail address for S. Jaglal: susan.jaglal{at}utoronto.ca

Background: The purpose of this study was to determine whether currently published outcome measures of physical function would be suitable for use for older adults with a hip fracture. The measures that were considered were the Musculoskeletal Function Assessment (MFA) Instrument, the Older Americans' Resources and Services (OARS) Multidimensional Functional Assessment Questionnaire physical function subscale, the Toronto Extremity Salvage Score (TESS), and the Short Form-36 (SF-36). Following suggestions by an expert panel and patient interviews, the MFA was not tested further. The TESS was modified and renamed the Lower Extremity Measure (LEM).

Methods: Forty-three community-dwelling patients with a hip fracture completed the LEM, OARS, and SF-36 in the hospital so that the prefracture status could be obtained; they were then followed prospectively at six weeks and at six months. All patients were interviewed twice in the hospital to assess the reliability of the LEM (intraclass correlation coefficient = 0.85). To establish criterion validity, the measures were compared with the Timed Up and Go (TUG) test at six weeks. We tested a number of hypotheses to determine construct validity.

Results: Only the LEM scores were significantly correlated with the TUG scores (r = -0.53, p = 0.03). The LEM scores were significantly correlated with the SF-36 subscale scores and the OARS scores. Patients with at least one comorbidity had a lower mean prefracture LEM score (90.0 ±9.7) than patients with no comorbidity (96.9 ±8.1) (p = 0.02). Patients who had used no walking aids before the fracture had a higher mean prefracture LEM score than those who had used a cane (95.5 ± 5.8 compared with 85.5 ±12.7; p = 0.0007). Both the LEM and the SF-36 scores changed significantly between all of the time-periods (p < 0.05). Measures of responsiveness indicated that the LEM was the best measure for detecting changes in physical function.

Conclusions: The LEM can detect clinically important changes in physical function over time in patients with a hip fracture and would be most useful for clinical trials or cohort studies. Orthopaedists who are currently utilizing the SF-36 can be reassured that the physical function subscale is a valid measure for patients with a hip fracture.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 J Bone Joint Surg BrHome page
P. Mattsson, A. Alberts, G. Dahlberg, M. Sohlman, H. C. Hyldahl, and S. Larsson
Resorbable cement for the augmentation of internally-fixed unstable trochanteric fractures: A PROSPECTIVE, RANDOMISED MULTICENTRE STUDY
J Bone Joint Surg Br, September 1, 2005; 87-B(9): 1203 - 1209.
[Abstract] [Full Text] [PDF]