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Craig A. Velozo, PhD, OTR/L; Michelle L. Woodbury, PhD, OTR/L DOI:10.1682/JRRD.2010.10.0203
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Assessing the Patient-SpecificFunctional Scale’s Ability to .docx
Assessing the Patient-Specific
Functional Scale’s Ability to Detect
Early Recovery Following
Total Knee Arthroplasty
Paul W. Stratford, Deborah M. Kennedy, Amy V. Wainwright
Background. The Patient-Specific Functional Scale (PSFS) has received consider-
able attention over the last 2 decades; however, validation studies have not examined
its performance in patients after total knee arthroplasty (TKA).
Objective. The purpose of this study was to investigate the ability of the PSFS to
detect change in patients post-TKA by comparing PSFS change scores with Lower
Extremity Functional Scale (LEFS) and pooled impairment change scores.
Methods. One hundred thirty-three patients participating in a post-TKA exercise
class were assessed at their initial and discharge visits. Initial assessments occurred
within 28 days of arthroplasty; follow-up assessments occurred within 80 days of
surgery. At both assessments, participants completed the PSFS, LEFS, and the P4 pain
measure, and their knee range of motion (ROM) and extensor strength were mea-
sured. The ability to detect change was expressed as the standardized response
mean (SRM) and as a correlation between the PSFS change scores and 2 reference
standards: (1) LEFS change scores and (2) pooled impairment change scores. The
pooled impairment measure consisted of pain, ROM, and strength change scores.
Results. The SRMs were PSFS 4.60 (95% confidence interval [CI]�4.00, 5.36) for
the PSFS and 2.28 (95% CI�2.04, 2.60) for the LEFS. The correlation between the
PSFS and pooled impairment change scores was 0.12 (95% CI��0.04, 0.25), and the
correlation between the PSFS and LEFS changes scores was 0.18 (0.02, 0.34).
Limitations. The order of measure administration was not standardized, and fixed
activity set does not reflect clinical application in many instances.
Conclusions. The results suggest that the PSFS is adept at detecting improvement
in patients post-TKA but that the PSFS, like other patient-specific measures, is likely
to be of limited value in distinguishing different levels of change among patients.
P.W. Stratford, PT, MSc, Institute
for Applied Sciences, School of
Rehabilitation Science, McMaster
University, 1400 Main St W, Ham-
ilton, Ontario, Canada LS8 1C7.
Address all correspondence to Mr
Stratford at: [email protected]
D.M. Kennedy, PT, MSc, Holland
Orthopaedic & Arthritic Centre,
Sunnybrook Health Sciences
Centre–Surgery, Toronto, Ontario,
Canada.
A.V. Wainwright, PT, MScPT, Hol-
land Orthopaedic & Arthritic Cen-
tre, Sunnybrook Health Sciences
Centre–Surgery.
[Stratford PW, Kennedy DM,
Wainwright AV. Assessing the
Patient-Specific Functional Scale’s
ability to detect early recovery
following total knee arthroplasty.
Phys Ther. 2014;94:838–844.]
© 2014 American Physical Therapy
Association
Published Ahead of Print:
February 20, 2014
Accepted: February 14, 2014
Submitted: August 28, 2013
Research Report
Post a Rapid Response to
this article at:
ptjournal.apta.org
838 f Physi ...
Assessing the Patient-SpecificFunctional Scale’s Ability to .docx
Assessing the Patient-Specific
Functional Scale’s Ability to Detect
Early Recovery Following
Total Knee Arthroplasty
Paul W. Stratford, Deborah M. Kennedy, Amy V. Wainwright
Background. The Patient-Specific Functional Scale (PSFS) has received consider-
able attention over the last 2 decades; however, validation studies have not examined
its performance in patients after total knee arthroplasty (TKA).
Objective. The purpose of this study was to investigate the ability of the PSFS to
detect change in patients post-TKA by comparing PSFS change scores with Lower
Extremity Functional Scale (LEFS) and pooled impairment change scores.
Methods. One hundred thirty-three patients participating in a post-TKA exercise
class were assessed at their initial and discharge visits. Initial assessments occurred
within 28 days of arthroplasty; follow-up assessments occurred within 80 days of
surgery. At both assessments, participants completed the PSFS, LEFS, and the P4 pain
measure, and their knee range of motion (ROM) and extensor strength were mea-
sured. The ability to detect change was expressed as the standardized response
mean (SRM) and as a correlation between the PSFS change scores and 2 reference
standards: (1) LEFS change scores and (2) pooled impairment change scores. The
pooled impairment measure consisted of pain, ROM, and strength change scores.
Results. The SRMs were PSFS 4.60 (95% confidence interval [CI]�4.00, 5.36) for
the PSFS and 2.28 (95% CI�2.04, 2.60) for the LEFS. The correlation between the
PSFS and pooled impairment change scores was 0.12 (95% CI��0.04, 0.25), and the
correlation between the PSFS and LEFS changes scores was 0.18 (0.02, 0.34).
Limitations. The order of measure administration was not standardized, and fixed
activity set does not reflect clinical application in many instances.
Conclusions. The results suggest that the PSFS is adept at detecting improvement
in patients post-TKA but that the PSFS, like other patient-specific measures, is likely
to be of limited value in distinguishing different levels of change among patients.
P.W. Stratford, PT, MSc, Institute
for Applied Sciences, School of
Rehabilitation Science, McMaster
University, 1400 Main St W, Ham-
ilton, Ontario, Canada LS8 1C7.
Address all correspondence to Mr
Stratford at: [email protected]
D.M. Kennedy, PT, MSc, Holland
Orthopaedic & Arthritic Centre,
Sunnybrook Health Sciences
Centre–Surgery, Toronto, Ontario,
Canada.
A.V. Wainwright, PT, MScPT, Hol-
land Orthopaedic & Arthritic Cen-
tre, Sunnybrook Health Sciences
Centre–Surgery.
[Stratford PW, Kennedy DM,
Wainwright AV. Assessing the
Patient-Specific Functional Scale’s
ability to detect early recovery
following total knee arthroplasty.
Phys Ther. 2014;94:838–844.]
© 2014 American Physical Therapy
Association
Published Ahead of Print:
February 20, 2014
Accepted: February 14, 2014
Submitted: August 28, 2013
Research Report
Post a Rapid Response to
this article at:
ptjournal.apta.org
838 f Physi.
Economic And Humanistic Outcomes Of Post Acs In Cardiac Rehabilitation Progra...
Cardiac Rehabilitation Program in Cardiac Center, Sarawak General Hospital.
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Assessing the Patient-SpecificFunctional Scale’s Ability to .docx
Assessing the Patient-Specific
Functional Scale’s Ability to Detect
Early Recovery Following
Total Knee Arthroplasty
Paul W. Stratford, Deborah M. Kennedy, Amy V. Wainwright
Background. The Patient-Specific Functional Scale (PSFS) has received consider-
able attention over the last 2 decades; however, validation studies have not examined
its performance in patients after total knee arthroplasty (TKA).
Objective. The purpose of this study was to investigate the ability of the PSFS to
detect change in patients post-TKA by comparing PSFS change scores with Lower
Extremity Functional Scale (LEFS) and pooled impairment change scores.
Methods. One hundred thirty-three patients participating in a post-TKA exercise
class were assessed at their initial and discharge visits. Initial assessments occurred
within 28 days of arthroplasty; follow-up assessments occurred within 80 days of
surgery. At both assessments, participants completed the PSFS, LEFS, and the P4 pain
measure, and their knee range of motion (ROM) and extensor strength were mea-
sured. The ability to detect change was expressed as the standardized response
mean (SRM) and as a correlation between the PSFS change scores and 2 reference
standards: (1) LEFS change scores and (2) pooled impairment change scores. The
pooled impairment measure consisted of pain, ROM, and strength change scores.
Results. The SRMs were PSFS 4.60 (95% confidence interval [CI]�4.00, 5.36) for
the PSFS and 2.28 (95% CI�2.04, 2.60) for the LEFS. The correlation between the
PSFS and pooled impairment change scores was 0.12 (95% CI��0.04, 0.25), and the
correlation between the PSFS and LEFS changes scores was 0.18 (0.02, 0.34).
Limitations. The order of measure administration was not standardized, and fixed
activity set does not reflect clinical application in many instances.
Conclusions. The results suggest that the PSFS is adept at detecting improvement
in patients post-TKA but that the PSFS, like other patient-specific measures, is likely
to be of limited value in distinguishing different levels of change among patients.
P.W. Stratford, PT, MSc, Institute
for Applied Sciences, School of
Rehabilitation Science, McMaster
University, 1400 Main St W, Ham-
ilton, Ontario, Canada LS8 1C7.
Address all correspondence to Mr
Stratford at: [email protected]
D.M. Kennedy, PT, MSc, Holland
Orthopaedic & Arthritic Centre,
Sunnybrook Health Sciences
Centre–Surgery, Toronto, Ontario,
Canada.
A.V. Wainwright, PT, MScPT, Hol-
land Orthopaedic & Arthritic Cen-
tre, Sunnybrook Health Sciences
Centre–Surgery.
[Stratford PW, Kennedy DM,
Wainwright AV. Assessing the
Patient-Specific Functional Scale’s
ability to detect early recovery
following total knee arthroplasty.
Phys Ther. 2014;94:838–844.]
© 2014 American Physical Therapy
Association
Published Ahead of Print:
February 20, 2014
Accepted: February 14, 2014
Submitted: August 28, 2013
Research Report
Post a Rapid Response to
this article at:
ptjournal.apta.org
838 f Physi ...
Assessing the Patient-SpecificFunctional Scale’s Ability to .docx
Assessing the Patient-Specific
Functional Scale’s Ability to Detect
Early Recovery Following
Total Knee Arthroplasty
Paul W. Stratford, Deborah M. Kennedy, Amy V. Wainwright
Background. The Patient-Specific Functional Scale (PSFS) has received consider-
able attention over the last 2 decades; however, validation studies have not examined
its performance in patients after total knee arthroplasty (TKA).
Objective. The purpose of this study was to investigate the ability of the PSFS to
detect change in patients post-TKA by comparing PSFS change scores with Lower
Extremity Functional Scale (LEFS) and pooled impairment change scores.
Methods. One hundred thirty-three patients participating in a post-TKA exercise
class were assessed at their initial and discharge visits. Initial assessments occurred
within 28 days of arthroplasty; follow-up assessments occurred within 80 days of
surgery. At both assessments, participants completed the PSFS, LEFS, and the P4 pain
measure, and their knee range of motion (ROM) and extensor strength were mea-
sured. The ability to detect change was expressed as the standardized response
mean (SRM) and as a correlation between the PSFS change scores and 2 reference
standards: (1) LEFS change scores and (2) pooled impairment change scores. The
pooled impairment measure consisted of pain, ROM, and strength change scores.
Results. The SRMs were PSFS 4.60 (95% confidence interval [CI]�4.00, 5.36) for
the PSFS and 2.28 (95% CI�2.04, 2.60) for the LEFS. The correlation between the
PSFS and pooled impairment change scores was 0.12 (95% CI��0.04, 0.25), and the
correlation between the PSFS and LEFS changes scores was 0.18 (0.02, 0.34).
Limitations. The order of measure administration was not standardized, and fixed
activity set does not reflect clinical application in many instances.
Conclusions. The results suggest that the PSFS is adept at detecting improvement
in patients post-TKA but that the PSFS, like other patient-specific measures, is likely
to be of limited value in distinguishing different levels of change among patients.
P.W. Stratford, PT, MSc, Institute
for Applied Sciences, School of
Rehabilitation Science, McMaster
University, 1400 Main St W, Ham-
ilton, Ontario, Canada LS8 1C7.
Address all correspondence to Mr
Stratford at: [email protected]
D.M. Kennedy, PT, MSc, Holland
Orthopaedic & Arthritic Centre,
Sunnybrook Health Sciences
Centre–Surgery, Toronto, Ontario,
Canada.
A.V. Wainwright, PT, MScPT, Hol-
land Orthopaedic & Arthritic Cen-
tre, Sunnybrook Health Sciences
Centre–Surgery.
[Stratford PW, Kennedy DM,
Wainwright AV. Assessing the
Patient-Specific Functional Scale’s
ability to detect early recovery
following total knee arthroplasty.
Phys Ther. 2014;94:838–844.]
© 2014 American Physical Therapy
Association
Published Ahead of Print:
February 20, 2014
Accepted: February 14, 2014
Submitted: August 28, 2013
Research Report
Post a Rapid Response to
this article at:
ptjournal.apta.org
838 f Physi.
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Cardiac Rehabilitation Program in Cardiac Center, Sarawak General Hospital.
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