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Clin Rehabil. 2015 Feb;29(2):165-74. doi: 10.1177/0269215514534088. Epub 2014 May 21.

A study of the inter-rater reliability of a test battery for use in patients after total hip replacement.

Author information

  • 1Interdisciplinary Research Unit, Silkeborg Regional Hospital, Silkeborg, Denmark lonemike@rm.dk.
  • 2Interdisciplinary Research Unit, Silkeborg Regional Hospital, Silkeborg, Denmark.
  • 3Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark.
  • 4Department of Physiotherapy- and Occupational Therapy, Aarhus University Hospital, Denmark.

Abstract

OBJECTIVE:

To assess the within-day inter-rater reliability of a test battery of functional performance, muscle strength and leg extension power on total hip replacement patients.

DESIGN:

A test-retest design was used.

SETTING:

Orthopaedic department at a Regional Hospital in Denmark.

SUBJECTS:

Two convenience samples of 20 total hip replacement patients were included.

INTERVENTION:

The tests were performed three months after total hip replacement. Two raters performed test and re-test, with two hours rest in-between.

MAIN MEASURES:

The test battery included: sit-to-stand performance, 20-metre maximum walking speed, stair climb performance, isometric muscle strength (hip abduction/flexion), and leg extension power. Absolute reliability was assessed with Bland Altman plots, standard error of measurement (SEM), and minimal detectable change. Relative reliability was assessed with intra-class correlation coefficient.

RESULTS:

Systematic differences between testers were seen in tests of walking speed (0.32 seconds p = 0.03) and stair climb performance (0.18 seconds p = 0.003). In per cent of the grand mean, the standard error of measurement was 3%-10%, indicating the measurement error on a group level, and the minimal detectable change was 10%-27%, indicating the measurement error on an individual level. The intra-class correlation coefficients were above 0.80 in all tests (range 0.83-0.95).

CONCLUSIONS:

The tests showed acceptable relative and absolute inter-rater reliability on a group level, but not on an individual level (except from test of walking speed and stair climb performance). Systematic differences between testers were considered clinically irrelevant (0.3 and 0.2 seconds).

© The Author(s) 2014.

KEYWORDS:

Arthroplasty; measurement error; muscle strength; reliability; walking

[PubMed - indexed for MEDLINE]
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