Article

The aim of this study was to evaluate the value of conventional factors,
the Risk Assessment and Predictor Tool (RAPT) and performance-based functional
tests as predictors of delayed recovery after total hip arthroplasty (THA).
METHOD: A prospective cohort study in a regional hospital in the Netherlands with
315 patients was attending for THA in 2012. The dependent variable recovery of
function was assessed with the Modified Iowa Levels of Assistance scale. Delayed
recovery was defined as taking more than 3 days to walk independently.
Independent variables were age, sex, BMI, Charnley score, RAPT score and scores
for four performance-based tests [2-minute walk test, timed up and go test (TUG),
10-meter walking test (10 mW) and hand grip strength]. RESULTS: Regression
analysis with all variables identified older age (>70 years), Charnley score C,
slow walking speed (10 mW >10.0 s) and poor functional mobility (TUG >10.5 s) as
the best predictors of delayed recovery of function. This model (AUC 0.85, 95% CI
0.79-0.91) performed better than a model with conventional factors and RAPT
scores, and significantly better (p = 0.04) than a model with only conventional factors (AUC 0.81, 95% CI 0.74-0.87). CONCLUSIONS:
The combination of
performance-based tests and conventional factors predicted inpatient functional
recovery after THA. Implications for Rehabilitation Two simple functional
performance-based tests have a significant added value to a more conventional
screening with age and comorbidities to predict recovery of functioning
immediately after total hip surgery. Patients over 70 years old, with
comorbidities, with a TUG score >10.5 s and a walking speed >1.0 m/s are at risk
for delayed recovery of functioning. Those high risk patients need an accurate
discharge plan and could benefit from targeted pre- and postoperative therapeutic
exercise programs.

Langue : ANGLAIS