Target setting for lower limb joint surgery using the Timed Up and Go test in patients with rheumatoid arthritis: A prospective cohort study

Abstract

Objective This prospective observational cohort study aimed to set targets for lower limb joint surgery based on the Timed Up and Go test (TUG), an objective functional outcome measure, in patients with established rheumatoid arthritis (RA). Methods We validated TUG as an outcome measure of lower limb joint surgery and compared it with changes in patient‐reported outcomes, including the Health Assessment Questionnaire Disability Index (HAQ‐DI) and European Quality of life scale with five dimensions (EQ‐5D). Changes in these outcomes were compared by performed surgery and by achievement of the minimal clinically important difference (MCID) for EQ‐5D using univariate analysis of variance. Associations between TUG and HAQ remission (HAQ‐DI ≤0.5) were determined using logistic regression analysis. Cut‐off values of TUG at baseline and 6 months after surgery for HAQ remission were determined using receiver operating characteristic curves. Results A total of 126 patients were analyzed. Mean age, HAQ‐DI, and TUG were 65.4 years, 1.036, and 12.8 seconds, respectively. After surgery, patients showed improvements in TUG as well as HAQ‐DI. TUG at 6 months after surgery was significantly associated with HAQ remission (adjusted OR: 0.78; 95% CI: 0.65‐0.93). TUG cut‐off values at baseline and 6 months after surgery for achieving HAQ remission were 12.1 and 8.8 seconds, respectively. Significant improvements in TUG (∆TUG, 3.7 seconds) were associated with achievement of the MCID for EQ‐5D (≥0.05) at 6 months after surgery. Conclusion Timed Up and Go test is a useful tool for assessing the outcome of lower limb joint surgery in RA patients. We propose that TUG ≤9 seconds could be an objective target for achieving good physical function after lower limb joint surgery.

Effect of preoperative sedentary behavior on clinical recovery after total knee arthroplasty: a prospective cohort study

“…A potential explanation is that TUG scores after TKA indicated relatively high gait function in the patients in the present study, which might have contributed to a floor effect. Specifically, TUG scores at the 6 months postoperative assessment (mean 8.2 s) were better than the cut-off value of this measure used to represent good physical function after TKA in a previous study (8.8 s) [15]. Therefore, it cannot be concluded that preoperative SB had no significant effect on improvement in TUG scores based on results of the present study.…”

Health‐related quality of life in rheumatoid arthritis: Systematic review and meta‐analysis of EuroQoL (EQ‐5D) utility scores from Asia

“…Thirty‐one studies reported utility scores of RA patients 22‐24,34‐42,45,47‐63,65 . The pooled mean EQ‐5D score was 0.66 (95% CI 0.63‐0.69) with high heterogeneity I 2 = 99.65% (Figure 2A).…”

“…Thirty-one studies reported utility scores of RA patie nts. [22][23][24][34][35][36][37][38][39][40][41][42]45,[47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63]65 The pooled mean EQ-5D score was 0.66 (95% CI 0.63-0.69) with high heterogeneity I 2 = 99.65% (Figure 2A).…”

Responsiveness of Isokinetic Dynamometry in Patients with Osteoarthritis after Knee and Hip Arthroplasty: A Prospective Repeated-Measures Cohort Study

“…The TUG is a performance-based PF measure, known to be valid, reliable, and responsive [44][45][46][47][48][49]. It has also been validated as a useful tool for the evaluation of PF after lower limb joint surgery [50]. TUG evaluates the time required for an individual to stand up from a regular armchair (with a seat height of 46 cm), walk a distance of 3 m, perform a turn, return to the chair and resume sitting [46].…”