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Scientific Articles   |    
The Timed Up and Go Test Is an Early Predictor of Functional Outcome After Hemiarthroplasty for Femoral Neck Fracture
George Y. Laflamme, MD, FRCSC1; Dominique M. Rouleau, MD, MSc, FRCSC1; Stéphane Leduc, MD, FRCSC1; Louis Roy, MD, FRCSC1; Eric Beaumont, PhD1
1 Centre de recherche, Département de chirurgie, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, local K-3035, 5400 boulevard Gouin ouest, Montréal, Québec H4J 2C5, Canada. E-mail address for E. Beaumont: e-beaumont@crhsc.rtss.qc.ca
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Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

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Centre de recherche, Département de chirurgie, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, local K-3035, 5400 boulevard Gouin ouest, Montréal, Québec H4J 2C5, Canada. E-mail address for E. Beaumont: e-beaumont@crhsc.rtss.qc.ca
Investigation performed at the Centre de recherche, Département de chirurgie, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Québec, Canada

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2012 Jul 03;94(13):1175-1179. doi: 10.2106/JBJS.J.01952
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Abstract

Background: 

The ability to predict the long-term physical function and prognosis of hip fracture patients during the early postoperative period is essential for surgeons and physical therapists as well as for patients and their families. The purpose of this study was to determine whether early functional assessment correlated with and/or predicted long-term function after surgery to treat a displaced femoral neck fracture.

Methods: 

Sixty-two patients undergoing hemiarthroplasty for a displaced femoral neck fracture were evaluated prospectively; a minimum follow-up of two years was required. Validated functional assessments, including the Lower Extremity Measure and the Timed Up and Go test, were utilized, and scores were analyzed with respect to patient baseline data.

Results: 

The functional level of patients decreased significantly after the injury, with the mean Lower Extremity Measure score decreasing from 87.7 to 62.4 and the need for a walking aid increasing from 36% to 54% at two years postoperatively (p < 0.05 for both). The Timed Up and Go test scores at four days and three weeks postoperatively were significantly higher in patients who needed a walking aid at two years compared with independently walking patients (p < 0.05). Receiver operating characteristic curve analysis of the Timed Up and Go test scores revealed that the optimal threshold for predicting the need for a walking aid at two years was fifty-eight seconds at four days postoperatively and twenty-six seconds at three weeks. Also, the need for a walking aid at two years was ninetyfold higher when the Timed Up and Go test score at three weeks postoperatively exceeded the twenty-six seconds threshold.

Conclusions: 

The Timed Up and Go test was an early clinical indicator of future physical function in patients with a hip fracture treated with hemiarthroplasty. Innovative clinical approaches to anticipate future function will contribute to increasing the efficiency of overall management of this growing set of patients.

Level of Evidence: 

Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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