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

Abstract

Introduction

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.

Results

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.

Conclusion

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.

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Fig. 1

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Acknowledgements

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.

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Correspondence to Aasis Unnanuntana.

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Unnanuntana, A., Jarusriwanna, A. & Nepal, S. Validity and responsiveness of Barthel index for measuring functional recovery after hemiarthroplasty for femoral neck fracture. Arch Orthop Trauma Surg 138, 1671–1677 (2018). https://doi.org/10.1007/s00402-018-3020-z

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Keywords

  • Femoral neck fracture
  • Hemiarthroplasty
  • Barthel index
  • Hip fracture
  • Functional recovery
  • Validity