Research Report Abstracts - Gesundheit

eS638
Research Report Platform Presentation
Number: RR-PL-1046 Thursday 23 June 15:00
RAI: Elicium D203-204
RELATIVE AND ABSOLUTE INTERTESTER
RELIABILITY OF THE TIMED UP & GO TEST
QUANTIFYING FUNCTIONAL MOBILITY IN
PATIENTS WITH HIP FRACTURE
Kristensen M.T. 1 , Henriksen S. 2 , Busk S. 2 , Kehlet H. 3 ,
Bandholm T. 4
1Copenhagen University Hospital, Hvidovre, Department
of Physiotherapy and Orthopaedic Surgery, Copenhagen,
Denmark, 2Copenhagen University Hospital, Hvidovre,
Department of Physiotherapy, Copenhagen, Denmark,
3Copenhagen University Hospital, Rigshospitalet, Section
of Surgical Pathophysiology, Copenhagen, Denmark,
4Copenhagen University Hospital, Hvidovre, Department of
Physiotherapy, Orthopaedic Surgery, and Clinical Research
Centre, Copenhagen, Denmark
Purpose: To examine the relative and absolute intertester
reliability of the Timed Up & Go (TUG) test, when performed
upon discharge from hospital, in patients with hip fracture.
Relevance: Physiotherapists often use tests to quantify functional
mobility at different time points during rehabilitation
in patients with hip fracture. The TUG test is probably the
number one test of functional mobility worldwide. Previous
studies have clarified that a standardised walking aid and the
best of 3 timed trials are needed to achieve valid data of the
TUG in patients with hip fracture. Still, the reliability of the
TUG, using this procedure is not known.
Participants: Thirty-six patients (25 women and 11 men)
with a median age of 80 (25–75% quartile, 66–84) years,
able to perform the TUG upon discharge from an acute
orthopaedic ward, were included. All patients had a high
mental status, 72% had a high prefracture functional level,
evaluated by the New Mobility Score, and the distribution of
patients with cervical and intertrochanteric fractures were 56
and 44%, respectively.
Methods: All patients performed the TUG in two separate
sessions (separated by 1.5 hours) using a rollator, at a mean
(SD) of 10 (6.5) days post-surgery. The best of 3 timed trials
from each session, which was supervised by two independent
physiotherapists (one session each), was used in analyses.
Analysis: The Intraclass Correlation Coefficient (ICC, 2.1),
the Standard Error of Measurement (SEM), and the Smallest
Real Difference (SRD) were calculated.
Results: The ICC, the SEM, and the SRD were respectively,
0.94 (95% CI, 0.89–0.97), 2.3 and 6.4 seconds. No systematic
between-rater difference was seen (P = 0.34), but some
heteroscedasticity occurred (r = 0.469, P = 0.004). That is,
the score-differences between sessions increased with poorer
TUG-performance. To accommodate for this, the SEM% and
the SRD% were calculated to 11.6% and 32.2%, respectively.
Accordingly, a group of patients with a mean TUG-score
of 20 seconds needs to improve by 2.3 seconds, to indicate
a real improvement, while a single patient with the same
TUG-score needs to improve by 6.4 seconds to indicate a real
improvement. The corresponding numbers for TUG-scores at
30 seconds are 3.5 and 9.7 seconds, respectively.
Conclusions: The relative intertester reliability of the TUG in
patients with hip fracture is high, with small changes needed
to indicate a real change for a group of patients, and somehow
larger changes needed for a single patient.
Implications: Different physiotherapists can administer the
TUG-test in the same patient, when changes in functional
mobility are assessed over time. The SRD shows that an
improvement of more than 6.4 seconds at retesting, for a
patient who used 20 seconds at baseline, should be regarded
as a real change in functional mobility (with a 95% certainty).
We recommend the TUG in patients with hip fracture, using
a rollator as a standardized walking aid when testing, and that
physiotherapists in clinical practice and research use the best
of 3 timed TUG-trials.
Keywords: Timed Up & Go test; Reliability; Hip fractures
Funding acknowledgements: IMK fund and the Association
of Danish Physiotherapists’ Research Fund, Copenhagen,
Denmark.
Ethics approval: This study was part of the Hvidovre University
Hospitals hip fracture project, which was approved
by the local ethics committee.
Research Report Poster Display
Number: RR-PO-305-16-Wed Wednesday 22 June 12:00
RAI: Exhibit Halls2&3
EFFECTIVENESS OF PHYSIOTHERAPY
INTERVENTIONS FOR PATIENTS WITH
SHOULDER IMPINGEMENT SYNDROME: A
SYSTEMATIC REVIEW
Kromer T.O. 1,2 , Tautenhahn U.G. 1 , de Bie R.A. 2,3,4 , Staal
J.B. 2,4,5 , Bastiaenen C.H.G. 2,3,4
1Physiotherapiezentrum, Penzberg, Germany, 2Maastricht University, CAPHRI School for Public Health and Primary
Care, Maastricht, Netherlands, 3Maastricht University,
Department of Epidemiology, Maastricht, Netherlands,
4Maastricht University, Centre for Evidence-Based Physiotherapy
(CEBP), Maastricht, Netherlands, 5Radboud University Nijmegen Medical Center, Nijmegen, Netherlands
Purpose: To examine the effectiveness of physiotherapy
interventions for patients presenting clinical signs of shoulder
impingement syndrome (SIS).
Relevance: Shoulder impingement syndrome is a common
musculoskeletal complaint leading to significant reduction
of health and disability. The present review aims to critically
summarize current evidence available for the effectiveness of
physiotherapy interventions for patients with SIS to support
physiotherapists in their clinical treatment decisions, their
evidence-based work, and to improve their treatment results.