Reliability and validity of the Four Square Step Test in patients with hip osteoarthritis before and after total hip replacement

Batting, M.; Barker, Karen

doi:10.1016/j.physio.2018.07.014

Cited by 10 publications

(11 citation statements)

References 25 publications

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“…Five articles [ 27 , 28 , 29 – 32 ] were excluded because the results from patients with THA were mixed to results of patients operated on for other orthopaedic conditions. One study was excluded because it was a reliability study [ 30 ], and another one was excluded because it did not report post-surgical data on balance assessment [ 33 ]. At the end of the selection protocol, 41 articles were included and evaluated for systematic review; of these, 33 were assessment studies [ 11 , 13 , 34 – 64 ], while the remaining 8 were rehabilitation training studies [ 65 – 72 ].…”

Section: Resultsmentioning

confidence: 99%

Balance and proprioception impairment, assessment tools, and rehabilitation training in patients with total hip arthroplasty: a systematic review

Labanca

Ciardulli

Bonsanto

et al. 2021

BMC Musculoskelet Disord

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Background Osteoarthritis and subsequent total hip arthroplasty (THA) lead to damages to hip joint mechanoceptors, which in turns lead to impairments in proprioception. One of the abilities mainly affected by an altered joint proprioception is balance. The aim of this work was to investigate the balance and proprioception impairments, current assessment tools, and rehabilitation training after THA. Methods A systematic literature revision was conducted on PubMed, Web of Science and Cochrane databases. Articles reporting balance and proprioception impairments, current assessment tools, or rehabilitation interventions were included. Methodological quality was assessed using the Downs and Black checklist. A total of 41 articles were included, 33 discussing balance and proprioception assessment, and 8 dealing with training. Data related to type of surgical approach, type and timing of assessment protocols, assessment instrumentation, and type, volume and duration of the rehabilitation training were extracted from each study. Results Thirty-one studies were of high quality, 2 of moderate quality and 8 of low-quality. Literature review showed an improvement in balance following THA in comparison with the pre-operative performance, although balance abnormalities persist up to 5 years after surgery, with THA patients showing an increased risk for falls. Balance training is effective in all the rehabilitation phases if specifically structured for balance enhancement and consistent in training volume. It remains unclear which assessments are more appropriate for the different rehabilitation phases, and if differences exist between the different surgical procedures used for THA. Only two studies assessed proprioception. Conclusion Balance and proprioception show impairments up to 5 years after THA, increasing the risk of falls. However, patients with THA may benefit of an adequate balance training. Further research is needed to investigate the gaps in balance and proprioception assessment and training following THA surgery.

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Section: Resultsmentioning

confidence: 99%

Balance and proprioception impairment, assessment tools, and rehabilitation training in patients with total hip arthroplasty: a systematic review

Labanca

Ciardulli

Bonsanto

et al. 2021

BMC Musculoskelet Disord

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“…Time taken for PWH to perform the FSST is much quicker than other populations. Those with hip OA reported 9.07(2.35), 3.7 (5.6) 33 knee OA 12.05 s 34 3.7 (5.6) 35 compared to PWH (median 8.225 s) despite some experiencing falls and multiple trips. Most other studies are in elderly populations and cite a time of over 15 s indicating a falls risk 10 .…”

Section: Discussionmentioning

confidence: 99%

“…The faster time indicated a better performance. This measure had good validity and reliability 10,14 . A time of 15 seconds and over indicates a fall risk.…”

Section: Methodsmentioning

confidence: 99%

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Validity of the four‐square step test in persons with haemophilia

2022

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Introduction Recurrent bleeds into joints causes arthropathy leading to pain and reduced joint movement. This may cause a reduction in postural balance and increase the falls risk in patients with haemophilia (PWH). With an ageing PWH population the need to assess functional balance in clinic will be essential to monitor function and implement interventions to help maintain balance and prevent falls. Aim To assess the utility of the Four‐Square Step Test (FSST) in PWH. Methods 80 PWH of all severity types were recruited and underwent a battery of outcome measures: FSST, Timed up & go (TUG), Short performance physical battery (SPPB), Haemophilia Activity List (HAL), ABC confidence questionnaire, and Haemophilia Joint Health score (HJHS). Demographics were collected, together with self‐reported falls/trips history. Results All 80 participants were able to complete all test measures. Median age 44.5 years. Number of participants reporting falls ranged from 23% in severe to 3% in mild. Recent trips 53% severe to 17% mild. Excellent Inter and intra‐reliability, ICC of .981 (CI .953–.992), P < .001 and ICC .989 (.983‐.993) P < .001, respectively. Strong correlations between FSST and TUG/ SPPB .753 and ‐.728, moderate correlation between FSST and ABC/HAL ‐.484, ‐.464 P < .01. Conclusion FSST is a valid and safe measure to use in PWH. It correlates strongly with other functional measures, has excellent inter and intra rater reliability. FSST correlates with age rather than severity type and provides information to the clinician on the speed/ability to change direction and clear an obstacle. ABC questionnaire was able to differentiate between severities and offers insight into patient confidence to move. SPPB had a ceiling effect with 52/80 scoring 12 and may not be suitable for PWH.

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Gait and Balance Assessment of Older Adults

Klima

Hood

2020

Curr Geri Rep

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Reliability and validity of the Four Square Step Test in patients with hip osteoarthritis before and after total hip replacement

Cited by 10 publications

References 25 publications

Balance and proprioception impairment, assessment tools, and rehabilitation training in patients with total hip arthroplasty: a systematic review

Balance and proprioception impairment, assessment tools, and rehabilitation training in patients with total hip arthroplasty: a systematic review

Validity of the four‐square step test in persons with haemophilia

Gait and Balance Assessment of Older Adults

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