Total Joint Arthroplasty and Outcome Measures (TJAOM) Toolkit
This article is currently under review and may not be up to date. Please come back soon to see the finished work! (11/06/2024)
The TJAOM Knowledge Translation Task Force
- TJAOM Toolkit 1.0 Team: Dr. Marie Westby, Ronda Field, Maureen Duggan, Dolores Langford, Robyn Laytham, Steven Longstaff, Phil Sweeney, Lauren Welch, Alison Hoens
- TJAOM Toolkit 2.0 Team: Dr. Marie Westby, Jane Burns, Melissa Idle, Clyde Smith, Aman Bajwa, Kelly Kavanagh, Jill Kipnis, Chiara Singh, Wing Ting Truong, Tony Hui, Paul Blazey, Jason Craig and Alison Hoens.
Introduction[edit | edit source]
The Total Joint Arthroplasty and Outcome Measures (TJAOM) Toolkit was developed by a dedicated task force comprising experts in the fields of physical therapy, orthopaedics, and rehabilitation. This toolkit aims to standardise and enhance the assessment of patients undergoing hip and knee replacement surgeries, ensuring consistent, high-quality care and improved patient outcomes.
The development of this toolkit is one of multiple Physical Therapy Knowledge Broker projects (including the Achilles Tendinopathy Toolkit and the Lateral Epicondyle Tendinopathy (Tennis Elbow) Toolkit) supported by the UBC Department of Physical Therapy, the Physiotherapy Association of BC, the Vancouver Coastal Research Institute, and the Providence Healthcare Research Institute.
The following information is current as of June 2024.
Purpose[edit | edit source]
The toolkit provides clinicians with a comprehensive guide to selecting and using appropriate outcome measures. It helps in capturing and interpreting patient progress, facilitating effective treatment planning, and improving communication between patients and healthcare providers.
Abbreviations Used in the Tookit[edit | edit source]
Abbreviations were used on this page, on the website and interactive PDFs, video lecture and template discharge letter. To see the full list click this link.
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Guide to using the Toolkit[edit | edit source]
Getting Started[edit | edit source]
- Access the Toolkit
- Visit the UBC TJAOM Toolkit for the complete set of resources.
- Understand the Structure
- The toolkit is divided into sections based on the type of joint (hip or knee) and includes both patient-reported outcome measures(PROMs) and performance-based tests (PBTs).
- Select Appropriate Measures
- Use the guidelines provided to select measures that are valid, reliable, responsive, and feasible for your clinical setting.
How to Use the Measures[edit | edit source]
- Review the Recommendations
- Familiarise yourself with the recommended outcome measures for hip and knee replacements.
- Using the Measures
- Follow the detailed instructions for administering each measure, considering patient factors and clinical feasibility.
- Interpret the Results
- Use the provided normative values, reference values, and minimal detectable change (MDC) or minimal clinically important difference (MCID) values to interpret the results meaningfully.
- Document and Communicate
- Record the results and discuss them with patients to enhance understanding and engagement in their care.
Recommended Outcome Measures[edit | edit source]
To ensure high-quality and consistent care for patients undergoing hip and knee replacement surgeries, the task force has identified a set of recommended outcome measures. These measures are divided into two categories: Patient-Reported Outcome Measures (PROMs) and Performance-Based Tests (PBTs).
Below are tables listing the recommended outcome measures, each with a brief description, the applicable phase(s) of care, and the relevant joint(s). For a more detailed overview of each measure, including phases, test description, ICF description, feasibility, time to complete, validity, reliability, and responsiveness, please click on the link provided in the table. Detailed descriptions can also be found further down the page.
Patient-Reported Outcome Measures (PROMs)[edit | edit source]
PROMs are an important tool , they provide feedback on a patient's health condition that comes directly from the patient and does not take into account any interpretation of the patient's response by a health professional. PROMs can take the form of questionnaires (in paper or electronic form) that include instructions and can be completed independently by the patient.
| Measure | Description | Phase | Joint |
|---|---|---|---|
| EuroQoL-5D-5L (EQ-5D-5L) | Generic measure of health status based on 5 dimensions of health | Pre-op, Post-acute, Active living | Hip, Knee |
| Forgotten Joint Score-12 (FJS-12) | Measures self-efficacy and lower extremity function | Post-acute, Active living | Hip, Knee |
| Knee Injury and Osteoarthritis Outcome Score (KOOS) | Measures pain, symptoms, function in daily living, sport and recreation, and HRQoL | Pre-op, Post-acute, Active living | Knee |
| KOOS-Joint Replacement (KOOS-JR) | Measures stiffness, pain, and ADL after TKA | Pre-op, Post-acute, Active living | Knee |
| Hip Disability and Osteoarthritis Outcome Score (HOOS) | Measures pain, other symptoms, function in daily living, sport and recreation, and HRQoL | Pre-op, Post-acute, Active living | Hip |
| HOOS-Joint Replacement (HOOS-JR) | Measures pain and function/daily living after THA | Pre-op, Post-acute, Active living | Hip |
| Lower Extremity Functional Scale (LEFS) | Measures current ability to do common activities at home, work, school, recreation, and sport | Pre-op, Post-acute, Active living | Hip, Knee |
| Numeric Pain Rating Scale (NPRS) | Measures pain intensity at rest or with activity | Pre-op, Acute, Post-acute, Active living | Hip, Knee |
| Oxford Hip Score (OHS) | Measures pain and function in relation to daily activities | Pre-op, Post-acute, Active living | Hip |
| Oxford Knee Score (OKS) | Measures pain and function in relation to daily activities | Pre-op, Post-acute, Active living | Knee |
| Pain Visual Analogue Scale (Pain VAS) | Measures pain intensity at rest or with activity | Pre-op, Acute, Post-acute, Active living | Hip, Knee |
| Patient Specific Functional Scale (PSFS) | Measures difficulty of 3 self-selected activities that the patient identifies as important | Pre-op, Acute, Post-acute, Active living | Hip, Knee |
Performance-Based Tests (PBTs)[edit | edit source]
Performance-Based clinical reported outcome measures require the patient to perform a task or set of movements that are supervised by a health care professional. Scores for performance-based measures can be either an objective measurement (e.g., time to complete a task) or a qualitative assessment that is assigned a score (e.g., normal or abnormal mechanics for a given task).
| Measure | Description | Phase | Joint |
|---|---|---|---|
| 4 Metre Walk Test (4mWT) | Measures gait speed and functional mobility | Pre-op, Acute, Post-acute, Active living | Hip, Knee |
| 10 Metre Walk Test (10mWT) | Measures gait speed and functional mobility | Pre-op, Acute, Post-acute, Active living | Hip, Knee |
| 40 Metre Fast-paced Walk Test (40mFPWT) | Measures gait speed and functional mobility at a fast pace | Pre-op, Post-acute, Active living | Hip, Knee |
| 6 Minute Walk Test (6MWT) | Measures submaximal aerobic capacity and ability to walk over longer distances | Pre-op, Post-acute, Active living | Hip, Knee |
| 30 Second Chair Stand Test (30sCST) | Measures lower limb function, dynamic balance, and strength | Pre-op, Post-acute, Active living | Hip, Knee |
| Balance Evaluation Systems Test (BESTest) | Measures dynamic balance, functional mobility, and gait | Pre-op, Post-acute, Active living | Hip, Knee |
| Brief Balance Evaluation Systems Test (Brief-BESTest) | Measures dynamic balance, functional mobility, and gait | Pre-op, Post-acute, Active living | Hip, Knee |
| Mini Balance Evaluation Systems Test (Mini-BESTest) | Measures dynamic balance, functional mobility, and gait | Pre-op, Post-acute, Active living | Hip, Knee |
| Berg Balance Scale (BBS) | Measures static and dynamic balance | Pre-op, Post-acute, Active living | Hip, Knee |
| Four Square Step Test (FSST, 4SST) | Measures dynamic balance | Pre-op, Acute, Post-acute, Active living | Hip, Knee |
| Functional Reach Test (FRT) | Measures static balance | Pre-op, Post-acute, Active living | Hip, Knee |
| Single Leg Stance (SLS) | Measures static balance | Pre-op, Post-acute, Active living | Hip, Knee |
| Stair Climb Test (SCT) | Measures functional strength, dynamic balance, and agility | Pre-op, Post-acute, Active living | Hip, Knee |
| Step Test (ST) | Measures lower extremity function, dynamic balance, and proprioception | Pre-op, Post-acute, Active living | Hip, Knee |
| Timed Up and Go (TUG, TUAG) | Measures strength, agility, mobility, dynamic balance, and gait | Pre-op, Acute, Post-acute, Active living | Hip, Knee |
All Outcome Measures[edit | edit source]
4 metre Walk Test (4mWT)
Measures gait speed & functional mobility Pre-op, Acute, Post-acute, Active living
10 metre Walk Test (10mWT) Measures gait speed & functional mobility Pre-op, Acute, Post-acute, Active living
40 metre Fast-paced Walk Test (40mFPWT) Measures gait speed and functional mobility at fast pace Pre-op, Post-acute, Active living
6 Minute Walk Test (6MWT) Measures submaximal aerobic capacity & ability to walk over longer distances Pre-op, Post-acute, Active living
30 second Chair Stand Test (30sCST) Measures lower limb function, dynamic balance & strength Pre-op, Post-acute, Active living
Berg Balance Scale (BBS) Measures static & dynamic balance Pre-op, Post-acute, Active living
Balance Evaluation Systems Test (BESTest) Measures dynamic balance, functional mobility & gait Pre-op, Post-acute, Active living
Brief Balance Evaluation Systems Test (Brief-BESTest) Measures dynamic balance, functional mobility & gait Pre-op, Post-acute, Active living
Mini Balance Evaluation Systems Test (Mini-BESTest) Measures dynamic balance, functional mobility & gait Pre-op, Post-acute, Active living
EuroQoL-5D-5L (EQ-5D-5L) Generic measure of health status based on 5 dimensions of health including mobility, self-care & pain Pre-op, Post-acute, Active living
Forgotten Joint Score-12 (FJS-12) Measures self-efficacy & lower extremity function Post-acute, Active living
Four Square Step Test (FSST, 4SST) Measures dynamic balance Pre-op, Acute, Post-acute, Active living
Functional Reach Test (FRT) Measures static balance Pre-op, Post-acute, Active living
Hip disability and Osteoarthritis Outcome Score (HOOS) Measures pain, other symptoms, function in daily living, sport and recreation & HRQoL Pre-op, Post-acute, Active living
Hip disability and Osteoarthritis Outcome Score – Joint Replacement (HOOS-JR) Measures pain & function/daily living after THA Pre-op, Post-acute, Active living
Knee injury and Osteoarthritis Outcome Score (KOOS) Measures pain, symptoms, function in daily living, sport and recreation & HRQoL Pre-op, Post-acute, Active living
Knee injury and Osteoarthritis Outcome Score – Joint Replacement (KOOS-JR) Measures stiffness, pain & ADL after TKA Pre-op, Post-acute, Active living
Lower Extremity Functional Scale (LEFS) Measures current ability to do common activities at home, work, school, recreation & sport Pre-op, Post-acute, Active living
Numeric Pain Rating Scale (NPRS) Measures pain intensity at rest or with activity Pre-op, Acute, Post-acute, Active living
Oxford Knee Score (OKS) Measures pain & function in relation to daily activities Pre-op, Post-acute, Active living
Oxford Hip Score (OHS) Measures pain & function in relation to daily activities Pre-op, Post-acute, Active living
Patient Specific Functional Scale (PSFS) Measures difficulty of 3 self-selected activities that the patient identifies as important Pre-op, Acute, Post-acute, Active living
Pain Visual Analogue Scale (Pain VAS) Measures pain intensity at rest or with activity Pre-op, Acute, Post-acute, Active living
Single Leg Stance (SLS) Measures static balance Pre-op, Post-acute, Active living
Stair Climb Test (SCT) Measures functional strength, dynamic balance & agility Pre-op, Post-acute, Active living
Step Test (ST) Measures lower extremity function, dynamic balance & proprioception Pre-op, Post-acute, Active living
Timed Up and Go (TUG, TUAG) Measures strength, agility, mobility, dynamic balance & gait Pre-op, Acute, Post-acute, Active living
Other Supporting Resources[edit | edit source]
- TJAOM Discharge Letter Template
- Video Rating Table
- Ratings of All Proposed Outcome Measures for TJAOM Toolkit
