The A-test: Assessment of functional recovery during early rehabilitation of patients in an orthopedic ward - content, criterion and construct validity

Aleksandra Vukomanovic, Aleksandar Djurovic, Zoran Popovic, Vesna Pejovic
2014 Vojnosanitetski Pregled  
Background/Aim. The A-test was designed for assessment of functional recovery during early rehabilitation of patients in an orthopedic ward. This performance-based test consists of 10 items for assessing basic activities by a six level ordinal scale (0-5). Total scores can range from 0 to 50, i.e. from inability to perform any activity despite the help of therapists to complete independence and safety in performing all activities. The aim of this study was to examine the A-test validity.
more » ... st validity. Methods. This prospective study was conducted in an orthopedic ward and included 120 patients [60 patients with hip osteoarthritis that underwent arthroplasty and 60 surgically treated patients with hip fracture (HF)] during early inpatient rehabilitation (1st-5th day). Validity was examined through 3 aspects: content validity -floor and ceiling effect, range, skewness; criterion validity -concurrent validity [correlation with the University of Iowa Level of Assistance Scale (ILAS) for patients with hip osteoarthritis, and with the Cumulated Ambulation Score (CAS) for patients with HF, Spearman rank correlation] and predictive validity [the New Mobility Score (NMS) 4 weeks after surgery, Mann-Whitney U test]; construct validity -4 hypotheses: 1) on the fifth day of rehabilitation in patients underwent arthroplasty due to hip osteoarthritis, the A-test results will strongly correlate with those of ILAS, while the Strana 716 VOJNOSANITETSKI PREGLED Volumen 71, Broj 8 Vukomanovi A, et al. Vojnosanit Pregl 2014; 71(8): 715-722. -konkurentna validnost [korelacija sa skalom The University of Iowa Level of Assistance Scale (ILAS) za bolesnike sa osteoartritisom kuka i sa skalom The Cumulated Ambulation Score (CAS) za bolesnike sa prelomom kuka, Spearman-ova rank korelacija] i prediktivna validnost [The New Mobility Score (NMS) 4 nedelje nakon operacije, Mann-Whitney U-test); validnost konstrukcije -ispitane su 4 hipoteze: 1) 5. dana rehabilitacije kod bolesnika kojima je ura ena artroplastika zbog osteoartritisa kuka rezultati A-testa bi e u ja oj korelaciji nego sa Harris hip skorom; 2) kod bolesnika sa prelomom kuka rezultati A-testa bi e zna ajno bolji kod onih kojima je dozvoljen oslonac na operisanu nogu toikom hoda nego kod onih kojima to nije dozvoljeno; 3) rezultat A-testa bi e zna ajno bolji kod bolesnika sa osteoartritisom kuka nego kod onih sa prelomom kuka; 4) rezultati A-testa bi e zna ajno bolji kod bolesnika mla ih od 65 godina nego kod onih koji imaju 65 godina. Rezultati. Ustanovljen je ni-zak pod (1%) i plafon (2%) efekt, opseg 0-50, koeficijent asimetrije 0,57, kao i snažna korelacija sa ILAS-om za bolesnike sa osteoartritisom kuka (r = -0,97, p = 0,000) i sa CAS-om za bolesnike sa prelomom kuka (r = 0,91, p = 0,000). Bolesnici koji su imali skor A-testa ve i od 35, petog dana nakon operacije (n = 46, Md = 4) imali su zna ajno ve i NMS skor 4 nedelje nakon operacije od bolesnika sa skorom A-testa manjim od 35 (n = 59, Md = 2), (U = 379, z = -6.47, p = 0,000, r = 0,63). Sve etiri hipoteze su potvr ene. Zaklju ak. A-test je jednostavan i validan instrument za svakodnevno pra enje brzine i stepena funkcionalnog oporavka tokom rane rehabilitacije hirurški le enih ortopedskih bolesnika. Klju ne re i: kuk, proteza; ortopedske procedure; postoperativni period; fizikalna terapija; funkcija, povratak; testovi, prognosti ka vrednost.
doi:10.2298/vsp130118038v pmid:25181829 fatcat:663vfctq2zefzmo6y5mkgoxh5e