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Development of a Clinical Prediction Rule to Identify Physical Activity After Total Hip Arthroplasty
Takumi Kawano1, Manabu Nankaku1, Masanobu Murao1
1Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan.
Objective:
To develop clinical prediction rule (CPR) of physical activity 1 year after total hip arthroplasty (THA).
Design:
Retrospective cohort study.
Setting:
University hospital with orthopedic surgery.
Participants:
The study group included 321 patients (56 men) who underwent primary THA (N=321).
Intervention:
Not applicable.
Main Outcomes Measures:
The data collected included age, body mass index, clinical score from the questionnaires, hip pain, range of motion, muscle strength, and Physical functions (10-meter walk test [10MWT], timed Up and Go test, sit-to-stand test). Patients were classified into sufficient and insufficient activity groups based on their University of California, Los Angeles (UCLA) activity score 1 year after THA. Variables measured preoperatively and 3 weeks postoperatively were analyzed using univariate and multivariate methods to derive CPR for physical activity.
Results:
A CPR was developed using the following 5 factors and cutoffs: age 70.5 years or younger, preoperative UCLA activity score ≥3.5, preoperative hip abduction strength ≥0.54 Nm/kg, preoperative knee extension strength ≥1.04 Nm/kg, and 10MWT ≤8.49 seconds 3 weeks after surgery. The presence of 4 of the 5 factors predicted a sufficient physical activity level at 1 year, with a positive likelihood ratio of 5.94 and probability of 85.4%. The presence of 5 predictor variables increased the probability of sufficient physical activity after THA to 94.7%.
Conclusions:
This study developed a CPR for physical activity 1 year after THA. Having 4 or more of the 5 measurements were useful indicators for predicting of physical activity 1 year postoperatively.
