Archives of Orthopaedic and Trauma Surgery

, Volume 138, Issue 12, pp 1671–1677 | Cite as

Validity and responsiveness of Barthel index for measuring functional recovery after hemiarthroplasty for femoral neck fracture

  • Aasis UnnanuntanaEmail author
  • Atthakorn Jarusriwanna
  • Sarthak Nepal
Trauma Surgery



To investigate the validity of Barthel Index (BI) compared with de Morton Mobility Index (DEMMI), EuroQol-visual analog scale (EQ-VAS), 2-min walk test (2MWT), and timed get-up-and-go test (TUG), and to evaluate the responsiveness of all outcome measures for assessing functional recovery in older patients who underwent hemiarthroplasty after femoral neck fracture.

Material and method

Eighty-one femoral neck fracture patients who were enrolled in a study evaluating functional recovery after bisphosphonate therapy during 2013 to 2015, and who had data available at both baseline and 12 months after surgery were included in this study.


All scores improved significantly from baseline to the 1-year follow-up. BI had moderate to strong correlation with DEMMI, 2MWT, and TUG (r-value: 0.490–0.843), and mild to moderate correlation with EQ-VAS (r-value: 0.278–0.323). All outcome measurements had high effect estimates. The minimal clinically important difference (MCID) of BI at 12 months was 9.8 points.


Since BI was shown to have good validity (moderate to strong correlation with DEMMI and performance-based tests, and mild to moderate correlation with EQ-VAS), BI can be used to accurately assess functional recovery in patients who undergo hemiarthroplasty after femoral neck fracture.


Femoral neck fracture Hemiarthroplasty Barthel index Hip fracture Functional recovery Validity 



The authors gratefully acknowledge Ms. Wachirapan Narktang of the Division of Research, Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital and Mr. Suthipol Udompunthurak of the Division of Clinical Epidemiology, Department of Health Research and Development, Faculty of Medicine Siriraj Hospital, for their assistance with data collection and statistical analyses.



Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

402_2018_3020_MOESM1_ESM.docx (13 kb)
Supplementary material 1 (DOCX 12 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Aasis Unnanuntana
    • 1
    Email author
  • Atthakorn Jarusriwanna
    • 1
    • 2
  • Sarthak Nepal
    • 1
  1. 1.Department of Orthopaedic Surgery, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
  2. 2.Department of Orthopaedics, Faculty of MedicineNaresuan UniversityPhitsanulokThailand

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