title: Preoperative prediction of inpatient recovery of function after total hip arthroplasty using performance-based tests: a prospective cohort study.
abstract: OBJECTIVE
  The aim of this study was to evaluate the value of conventional factors, the Risk Assessment and Predictor Tool (RAPT) and performance-based functional tests as predictors of delayed recovery after total hip arthroplasty (THA).
  
  
  METHODS
  A prospective cohort study in a regional hospital in the Netherlands with 315 patients was attending for THA in 2012. The dependent variable recovery of function was assessed with the Modified Iowa Levels of Assistance scale. Delayed recovery was defined as taking more than 3 days to walk independently. Independent variables were age, sex, BMI, Charnley score, RAPT score and scores for four performance-based tests [2-minute walk test, timed up and go test (TUG), 10-meter walking test (10 mW) and hand grip strength].
  
  
  RESULTS
  Regression analysis with all variables identified older age (>70 years), Charnley score C, slow walking speed (10 mW >10.0 s) and poor functional mobility (TUG >10.5 s) as the best predictors of delayed recovery of function. This model (AUC 0.85, 95% CI 0.79-0.91) performed better than a model with conventional factors and RAPT scores, and significantly better (p = 0.04) than a model with only conventional factors (AUC 0.81, 95% CI 0.74-0.87).
  
  
  CONCLUSIONS
  The combination of performance-based tests and conventional factors predicted inpatient functional recovery after THA.
  
  
  CONCLUSIONS
  Two simple functional performance-based tests have a significant added value to a more conventional screening with age and comorbidities to predict recovery of functioning immediately after total hip surgery. Patients over 70 years old, with comorbidities, with a TUG score >10.5 s and a walking speed >1.0 m/s are at risk for delayed recovery of functioning. Those high risk patients need an accurate discharge plan and could benefit from targeted pre- and postoperative therapeutic exercise programs.
authors: a Department of Physical Therapy , Gelderse Vallei Hospital , Ede , The Netherlands .|b Department of Epidemiology and Caphri Research School , Maastricht University Medical Centre , Maastricht , The Netherlands .
authors: Ellen
authors: E
authors: Oosting
authors: c Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare , Nijmegen , The Netherlands , and.
authors: Thomas J
authors: TJ
authors: Hoogeboom
authors: a Department of Physical Therapy , Gelderse Vallei Hospital , Ede , The Netherlands .
authors: Suzan A
authors: SA
authors: Appelman-de Vries
authors: d Department of Orthopedics , Gelderse Vallei Hospital , Ede , The Netherlands , and.
authors: Adam
authors: A
authors: Swets
authors: a Department of Physical Therapy , Gelderse Vallei Hospital , Ede , The Netherlands .
authors: Jaap J
authors: JJ
authors: Dronkers
authors: b Department of Epidemiology and Caphri Research School , Maastricht University Medical Centre , Maastricht , The Netherlands .|e Health∼Holland, Topsector Life Sciences and Health , The Hague , The Netherlands.
authors: Nico L U
authors: NL
authors: van Meeteren
mesh_terms: D000367:Age Factors; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods / Q000534:rehabilitation; D015897:Comorbidity; D051341:Dependent Ambulation; D004185:Disability Evaluation; D005260:Female; D018737:Hand Strength; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D009426:Netherlands; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016138:Walking
keywords: Functional status; preoperative; risk assessment; total hip arthroplasty