title: Using outcome measure results to facilitate clinical decisions the first year after total hip arthroplasty.
abstract: METHODS
  Variable-occasion, repeated-measures design.
  
  
  OBJECTIVE
  To model change in lower extremity functional status of patients 1 year after total hip arthroplasty (THA), using the Lower Extremity Functional Scale (LEFS) and the 6-minute walk test (6MWT), and, secondarily, to provide clinicians with useful data to guide practice.
  
  
  BACKGROUND
  Given the prevalence of THA and current resource pressures, standardized outcome measures play an important role in providing physical therapists with objective knowledge about postoperative recovery and prognosis.
  
  
  METHODS
  Seventy-five patients, with a mean age of 61 years and a diagnosis of hip osteoarthritis, consented to participate in the study. Assessments were conducted preoperatively and at multiple time points for up to 65 weeks postoperatively. Recovery was modeled using a nonlinear robust regression analysis for clustered data. The predictive ability of age, body mass index, and preoperative score was explored.
  
  
  RESULTS
  Gender-based recovery curves were generated to depict the rate and amount of change in LEFS scores and 6MWT distances over the first year. Preoperative baseline 6MWT distance was the only covariate predictive of postarthroplasty 6MWT distances for both males and females. None of the covariates examined were significantly associated with postarthroplasty LEFS scores.
  
  
  CONCLUSIONS
  Although there were variations in the recovery curves by measure, general patterns were noted. There was a rapid increase in both self-reported and physical performance measure scores for 12 to 15 weeks. Thereafter, we observed a slowing of recovery, with a plateau at 30 to 35 weeks for the 6MWT and later for the LEFS. These data can be used to make evidence-based decisions regarding prognosis and to guide the setting of measurable treatment goals.
  
  
  METHODS
  Prognosis, level 1b.
authors.affiliation: Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. d.kennedy@utoronto.ca
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Kennedy
authors.forename: Paul W
authors.initials: PW
authors.lastname: Stratford
authors.forename: Susan
authors.initials: S
authors.lastname: Robarts
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Gollish
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000503:physiopathology / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D011379:Prognosis; D020127:Recovery of Function; D012044:Regression Analysis; D016138:Walking / Q000502:physiology