Indoor and outdoor 10-Meter Walk Test and Timed Up and Go in patients after total hip arthroplasty: a reliability and comparative study

Federico Temporiti; Chiara Casirati; Paola Adamo; Davide De Leo; Giorgia Marino; Guido Grappiolo; Roberto Gatti

doi:10.33393/aop.2024.3267

Authors

Federico Temporiti Physiotherapy Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan - Italy and Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan - Italy https://orcid.org/0000-0003-1771-2365
Chiara Casirati Physiotherapy Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan - Italy
Paola Adamo Physiotherapy Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan - Italy
Davide De Leo Physiotherapy Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan - Italy https://orcid.org/0000-0002-7940-7203
Giorgia Marino Physiotherapy Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan - Italy
Guido Grappiolo Hip and Knee Orthopaedic Surgery Department, IRCCS Humanitas Research Hospital, Rozzano, Milan - Italy
Roberto Gatti Physiotherapy Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan - Italy and Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan - Italy

DOI:

https://doi.org/10.33393/aop.2024.3267

Keywords:

Gait performance, Hip arthroplasty, Indoor setting, Mobility, Outdoor setting

Abstract

Introduction: The 10-Meter Walk Test (10MWT) and Timed Up and Go (TUG) are valid tools for gait performance and mobility assessment after total hip arthroplasty (THA). The study aimed to assess test-retest reliability of 10MWT and TUG in indoor and outdoor environments in patients in acute phase after THA and compare their indoor vs. outdoor performance during these tests.

Methods: Thirty-five inpatients performed 10MWT and TUG in indoor and outdoor settings on the second postoperative day. An additional evaluation session was performed after 1 hour under the supervision of the same operator. Test-retest reliability was assessed using Intraclass Correlation Coefficient (ICC: 2.1) and Minimal Detectable Change (MDC₉₅), while paired t-tests were used to compare indoor vs. outdoor performance.

Results: Indoor (ICC: 0.94, MDC₉₅: 0.13 m/s) and outdoor (ICC: 0.91, MDC₉₅: 0.16 m/s) 10MWT at maximum speed and indoor (ICC: 0.92, MDC₉₅: 2.5 s) and outdoor (ICC: 0.93, MDC₉₅: 2.4 s) TUG revealed excellent reliability. Indoor (ICC: 0.86, MDC₉₅: 0.16 m/s) and outdoor (ICC: 0.89, MDC₉₅: 0.16 m/s) 10MWT at spontaneous speed revealed good reliability. Spontaneous (mean difference [MD]: 0.05 m/s, 95% confidence interval [CI₉₅]: 0.03, 0.07, p < 0.001) and maximum (MD: 0.02 m/s, CI₉₅: 0.01, 0.04, p < 0.001) 10MWT revealed higher gait speed when performed outdoors compared to indoors.

Conclusions: Indoor and outdoor 10MWT and TUG are reliable tests in acute phase after THA. Higher gait speed during outdoor 10MWT may depend on test score variability, due to MDs being lower than MDC₉₅.

Downloads

Download data is not yet available.

References

Sato EH, Stevenson KL, Blackburn BE, et al. Impact of demographic variables on recovery after total hip arthroplasty. J Arthroplasty. 2024;39(3):721-726. https://doi.org/10.1016/j.arth.2023.09.012 PMID:37717829 DOI: https://doi.org/10.1016/j.arth.2023.09.012

Ohta Y, Sugama R, Minoda Y, et al. Is the anterolateral or posterolateral approach more effective for early postoperative recovery after minimally invasive total hip arthroplasty? J Clin Med. 2022;12(1):139. https://doi.org/10.3390/jcm12010139 PMID:36614940 DOI: https://doi.org/10.3390/jcm12010139

Temporiti F, Draghici I, Fusi S, et al. Does walking the day of total hip arthroplasty speed up functional independence? A non-randomized controlled study. Arch Physiother. 2020;10(1):8. https://doi.org/10.1186/s40945-020-00079-7 PMID:32346488 DOI: https://doi.org/10.1186/s40945-020-00079-7

Papalia R, Zampogna B, Torre G, et al. Preoperative and perioperative predictors of length of hospital stay after primary total hip arthroplasty – our experience on 743 cases. J Clin Med. 2021;10(21):5053. https://doi.org/10.3390/jcm10215053 PMID:34768573 DOI: https://doi.org/10.3390/jcm10215053

Yang G, Chen W, Chen W, Tang X, Huang Y, Zhang L. Feasibility and safety of 2-day discharge after fast-track total hip arthroplasty: a Chinese experience. J Arthroplasty. 2016;31(8):1686-1692.e1. https://doi.org/10.1016/j.arth.2016.02.011 PMID:26968693 DOI: https://doi.org/10.1016/j.arth.2016.02.011

Fraser JF, Danoff JR, Manrique J, Reynolds MJ, Hozack WJ. Identifying reasons for failed same-day discharge following primary total hip arthroplasty. J Arthroplasty. 2018;33(12):3624-3628. https://doi.org/10.1016/j.arth.2018.08.003 PMID:30172415 DOI: https://doi.org/10.1016/j.arth.2018.08.003

Latham NK, Mehta V, Nguyen AM, et al. Performance-based or self-report measures of physical function: which should be used in clinical trials of hip fracture patients? Arch Phys Med Rehabil. 2008;89(11):2146-2155. https://doi.org/10.1016/j.apmr.2008.04.016 PMID:18996244 DOI: https://doi.org/10.1016/j.apmr.2008.04.016

Yeung TS, Wessel J, Stratford PW, MacDermid JC. The timed up and go test for use on an inpatient orthopaedic rehabilitation ward. J Orthop Sports Phys Ther. 2008;38(7):410-417. https://doi.org/10.2519/jospt.2008.2657 PMID:18591756 DOI: https://doi.org/10.2519/jospt.2008.2657

Kennedy DM, Stratford PW, Wessel J, Gollish JD, Penney D. Assessing stability and change of four performance measures: a longitudinal study evaluating outcome following total hip and knee arthroplasty. BMC Musculoskelet Disord 2005;6:3. https://doi.org/10.1186/1471-2474-6-3 PMID: 15679884 DOI: https://doi.org/10.1186/1471-2474-6-3

Unver B, Baris RH, Yuksel E, Cekmece S, Kalkan S, Karatosun V. Reliability of 4-meter and 10-meter walk tests after lower extremity surgery. Disabil Rehabil. 2017;39(25):2572-2576. https://doi.org/10.1080/09638288.2016.1236153 PMID:27728985 DOI: https://doi.org/10.1080/09638288.2016.1236153

Doll H, Gentile B, Bush EN, Ballinger R. Evaluation of the measurement properties of four performance outcome measures in patients with elective hip replacements, elective knee replacements, or hip fractures. Value Health. 2018;21(9):1104-1114. https://doi.org/10.1016/j.jval.2018.02.006 PMID:30224116 DOI: https://doi.org/10.1016/j.jval.2018.02.006

Halket A, Stratford PW, Kennedy DM, Woodhouse LJ, Spadoni G. Measurement properties of performance-specific pain ratings of patients awaiting total joint arthroplasty as a consequence of osteoarthritis. Physiother Can. 2008;60(3):255-263. https://doi.org/10.3138/physio.60.3.255 PMID:20145758 DOI: https://doi.org/10.3138/physio.60.3.255

Zukowski LA, Tennant JE, Iyigun G, Giuliani CA, Plummer P. Dual-tasking impacts gait, cognitive performance, and gaze behavior during walking in a real-world environment in older adult fallers and non-fallers. Exp Gerontol. 2021;150:111342. https://doi.org/10.1016/j.exger.2021.111342 PMID:33838215 DOI: https://doi.org/10.1016/j.exger.2021.111342

Olmos LE, Freixes O, Gatti MA, et al. Comparison of gait performance on different environmental settings for patients with chronic spinal cord injury. Spinal Cord. 2008;46(5):331-334. https://doi.org/10.1038/sj.sc.3102132 PMID:17923845 DOI: https://doi.org/10.1038/sj.sc.3102132

Schmitt AC, Baudendistel ST, Lipat AL, White TA, Raffegeau TE, Hass CJ. Walking indoors, outdoors, and on a treadmill: gait differences in healthy young and older adults. Gait Posture. 2021;90:468-474. https://doi.org/10.1016/j.gaitpost.2021.09.197 PMID:34619613 DOI: https://doi.org/10.1016/j.gaitpost.2021.09.197

Ciccarelli P, Urakcheeva I, Biondi A, Torre M. Italian Arthroplasty Registry. Annual Report 2021 – Addendum, 1st ed. Roma: Il pensiero scientifico editore, 2022; 29. https://riap.iss.it/riap/en/activities/reports-en/2023/07/10/annual-report-2021-english-addendum/ (Accessed August 2024)

Loppini M, Longo UG, Caldarella E, Rocca AD, Denaro V, Grappiolo G. Femur first surgical technique: a smart non-computer-based procedure to achieve the combined anteversion in primary total hip arthroplasty. BMC Musculoskelet Disord. 2017;18(1):331. https://doi.org/10.1186/s12891-017-1688-9 PMID:28764697 DOI: https://doi.org/10.1186/s12891-017-1688-9

Temporiti F, De Leo D, Adamo P, et al. Impaired modulation of motor and functional performance in patients after total knee arthroplasty: a prospective observational study. BioMed Res Int. 2022;2022:4546836. https://doi.org/10.1155/2022/4546836 PMID:36072468 DOI: https://doi.org/10.1155/2022/4546836

Grant S, Aitchison T, Henderson E, et al. A comparison of the reproducibility and the sensitivity to change of visual analogue scales, Borg scales, and Likert scales in normal subjects during submaximal exercise. Chest. 1999;116(5):1208-1217. https://doi.org/10.1378/chest.116.5.1208 PMID:10559077 DOI: https://doi.org/10.1378/chest.116.5.1208

Yuksel E, Unver B, Kalkan S, Karatosun V. Reliability and minimal detectable change of the 2-minute walk test and Timed Up and Go test in patients with total hip arthroplasty. Hip Int. 2021;31(1):43-49. https://doi.org/10.1177/1120700019888614 PMID:31928090 DOI: https://doi.org/10.1177/1120700019888614

Ruspi A, De Leo D, Scandelli F, et al. Recommendations on the use of restrictions and assistive devices after total hip arthroplasty: an adolopment of guidelines. Disabil Rehabil. In press.

Walter SD, Eliasziw M, Donner A. Sample size and optimal designs for reliability studies. Stat Med. 1998;17(1):101-110. https://doi.org/10.1002/(SICI)1097-0258(19980115)17:1<101::AID-SIM727>3.0.CO;2-E PMID:9463853 DOI: https://doi.org/10.1002/(SICI)1097-0258(19980115)17:1<101::AID-SIM727>3.3.CO;2-5

Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155-163. https://doi.org/10.1016/j.jcm.2016.02.012 PMID:27330520 DOI: https://doi.org/10.1016/j.jcm.2016.02.012

Durlak JA. How to select, calculate, and interpret effect sizes. J Pediatr Psychol. 2009;34(9):917-928. https://doi.org/10.1093/jpepsy/jsp004 PMID:19223279 DOI: https://doi.org/10.1093/jpepsy/jsp004

van den Akker-Scheek I, Stevens M, Bulstra SK, Groothoff JW, van Horn JR, Zijlstra W. Recovery of gait after short-stay total hip arthroplasty. Arch Phys Med Rehabil. 2007;88(3):361-367. https://doi.org/10.1016/j.apmr.2006.11.026 PMID:17321830 DOI: https://doi.org/10.1016/j.apmr.2006.11.026

Kirschner J, Michel S, Becker R, et al. Determination of relationships between symmetry-based, performance-based, and functional outcome measures in patients undergoing total hip arthroplasty. J Pers Med 2023;13(7):1046. https://doi.org/10.3390/jpm13071046 PMID: 37511659 DOI: https://doi.org/10.3390/jpm13071046

Lieberman JR, Dorey F, Shekelle P, et al. Differences between patients’ and physicians’ evaluations of outcome after total hip arthroplasty. J Bone Joint Surg Am. 1996;78(6):835-838. https://doi.org/10.2106/00004623-199606000-00005 PMID:8666600 DOI: https://doi.org/10.2106/00004623-199606000-00005

Dijkers MP, Kropp GC, Esper RM, Yavuzer G, Cullen N, Bakdalieh Y. Reporting on reliability and validity of outcome measures in medical rehabilitation research. Disabil Rehabil. 2002;24(16):819-827. https://doi.org/10.1080/09638280210148585 PMID:12450458 DOI: https://doi.org/10.1080/09638280210148585

Donovan K, Lord SE, McNaughton HK, Weatherall M. Mobility beyond the clinic: the effect of environment on gait and its measurement in community-ambulant stroke survivors. Clin Rehabil. 2008;22(6):556-563. https://doi.org/10.1177/0269215507085378 PMID:18511535 DOI: https://doi.org/10.1177/0269215507085378

Clark DJ, Rose DK, Ring SA, Porges EC. Utilization of central nervous system resources for preparation and performance of complex walking tasks in older adults. Front Aging Neurosci. 2014;6:217. https://doi.org/10.3389/fnagi.2014.00217 PMID:25202270 DOI: https://doi.org/10.3389/fnagi.2014.00217

Singh JA, Schleck C, Harmsen S, Lewallen D. Clinically important improvement thresholds for Harris Hip Score and its ability to predict revision risk after primary total hip arthroplasty. BMC Musculoskelet Disord. 2016;17(1):256. https://doi.org/10.1186/s12891-016-1106-8 PMID:27286675 DOI: https://doi.org/10.1186/s12891-016-1106-8

Gooch K, Marshall DA, Faris PD, et al. Comparative effectiveness of alternative clinical pathways for primary hip and knee joint replacement patients: a pragmatic randomized, controlled trial. Osteoarthritis Cartilage. 2012;20(10):1086-1094. https://doi.org/10.1016/j.joca.2012.06.017 PMID:22796513 DOI: https://doi.org/10.1016/j.joca.2012.06.017