Comparative responsiveness of locomotor tests and questionnaires used to follow early recovery after total knee arthroplasty.
OBJECTIVE
To compare the responsiveness of 3 locomotor tests and 2 questionnaires in the early stage after a total knee arthroplasty (TKA) and to determine if the 4 responsiveness statistics ranked the measures similarly.


METHODS
Longitudinal study.


METHODS
Rehabilitation institute.


METHODS
Twenty-five men and 40 women with knee osteoarthritis scheduled for a first TKA.


METHODS
Not applicable.


METHODS
Six-minute gait distance, in-laboratory gait speed and stair ascent duration, Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index difficulty subscale, and Medical Outcomes Study Short-Form 36-Item Health Survey role-physical and physical functioning subscale scores. Effect size, standardized response mean, paired t test, and relative efficiency statistics were computed for 3 time intervals: (1) before TKA to 2 months after TKA, (2) 2 to 4 months after TKA, and (3) before TKA to 4 months after TKA.


RESULTS
Responsiveness varied according to tests and intervals considered. For all intervals, the WOMAC difficulty subscale was the most responsive questionnaire and the 6-minute gait test was the most responsive locomotor test. Stair ascent duration was the least responsive measure. Of the responsiveness indices used, only effect size ranked the tests differently.


CONCLUSIONS
The 6-minute gait test and the WOMAC difficulty subscale are recommended for outcome assessment during the early recovery period after TKA. Because interpretation guidelines are available and confidence intervals can be calculated for it, the standardized response mean is the most useful statistic.
Parent
Eric
E
Department of Rehabilitation, Laval University, and Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec Rehabilitation Institute, Quebec City, Que., Canada.
Moffet
Hélène
H
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery; D011594:Psychometrics; D011788:Quality of Life; D016059:Range of Motion, Articular; D020127:Recovery of Function; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D016896:Treatment Outcome