Objective: To assess advanced locomotor performance with the timed stair test (TST) and to determine if the level of performance of a group of women one year after hip replacement changed with the functional demands of the tasks.
Design: Comparison of the performance of two groups of women.
Setting: General community.
Participants: A convenient sample including 18 women who had had a total hip replacement 11 months earlier (patients) and 15 healthy age-matched women (comparison group).
Main outcome measures: Three tests were administered: the 10-m walk test, the unloaded TST and the loaded TST (10 kg). The duration of each test was recorded and transformed into speed and the level of performance was assessed by calculating percentage deficit using corresponding values from the comparison group. The TST is made of four subtasks: (1) standing up and walking, (2) ascending stairs, (3) turning and descending stairs, (4) walking back, turning and sitting down.
Results: Significant differences in performance were found for all three tests with the patients showing a slower performance. The percentage deficits increased significantly from the less difficult (walking: 18%) to the more difficult conditions (unloaded TST: 23% and loaded TST: 28%), with the greatest deficits found during stair descent. Strong correlations were also found between walking deficits and TST deficits (loaded: r = 0.82; unloaded: r = 0.88).
Conclusions: By combining mobility, walking and stair activities, the TST can be used to assess various components of advanced locomotor performance. The progressive level of difficulty of the TST subtasks as well as the addition of a load make it useful to detect subtle locomotor disabilities.
Get full access to this article
View all access options for this article.
References
1.
Freburger JK. An analysis of the relationship between the utilization of physical therapy services and outcomes of care for patients after total hip arthroplasty. Phys Ther2000; 80: 448–458.
2.
Murray MP, Brewer BJ, Zuege RC. Kinesiologic measurements of functional performance before and after McKee-Farrar total hip replacement. J Bone Joint Surg Am1972; 54A: 237–256.
3.
Murray MP, Brewer BJ, Gore DR, Zuege RC. Kinesiology after McKee-Farrar total hip replacement. J Bone Joint Surg Am1975; 57A: 337–342.
4.
Olsson E, Goldie I, Wykman A. Total hip replacement. Scand J Rehabil Med1985; 18: 107–116.
5.
Brown M, Hislop HJ, Waters RL, Porell D. Walking efficiency before and after total hip replacement. Phys Ther1980; 10: 1259–1263.
6.
Loizeau J, Allard P, Duhaime M, Landjerit B. Bilateral gait patterns in subjects fitted with a total hip prosthesis. Arch Phys Med Rehabil1995; 76: 552–557.
7.
Ajemian S, Thon D, Kaul L, Clare P, Hughes G, Zernicke R. Gait changes following total hip replacement. Gait Posture1997; 2: 146–147.
8.
Perron M, Malouin F, Moffet H, McFadyen BJ. Three-dimensional gait analysis in women with a hip arthroplasty. Clin Biomech2000; 15: 504–515.
9.
Vaz MD, Kramer JF, Rorabeck CH, Bourne RB. Isometric hip abductor strength following total hip replacement and its relationship to functional assessment. J Orthop Sports Phys Ther1993; 18: 526–531.
10.
Shih CH, Du YK, Lin YH, Wu CC. Muscular recovery around the hip joint after total arthrosplasty. Clin Orthop1994; 302: 115–120.
11.
Murray MP, Gore DR, Brewer BJ, Zuege RC, Gardner BS. Comparison of functional performance after McKee-Farrar, Charnley, and Müller total hip replacement. Clin Orthop1976; 121: 33–43.
12.
McBeath AA, Bahrke MS, Balke B. Walking efficiency before and after McKee-Farrar total hip replacement. J Bone Joint Surg Am1980; 54A: 237–256.
13.
Macnicol MF, Hardy R, Chalmers J. Exercise testing before and after hip arthroplasty. J Bone Joint Surg Br1980; 62B: 326–331.
14.
Wright JG, Young NL. The patient-specific index: asking patients what they want. J Bone Joint Surg Am1997; 79A: 974–983.
15.
Laupacis A, Bourne R, Robabeck C et al. The effect of elective total hip replacement on health-related quality of life. J Bone Joint Surg Am1993; 75A: 1619–1626.
16.
Murray MP, Gore DR, Brewer BJ, Gardner GM, Sepic SB. A comparison of the functional performance of patients with Charnley and Müller total hip replacement. Acta Orthop Scand1979; 50: 563–569.
17.
Wykman A, Olsson E. Walking ability after total hip replacement. J Bone Joint Surg Br1992; 74B: 53–56.
18.
Tanaka Y. Gait analysis of patients with osteoarthritis of the hip and those with total hip arthroplasty. J Jpn Orthop Asssoc1993; 67: 1001–1013.
19.
Long WL, Dorr LD, Healy B, Perry J. Functional recovery of noncemented total hip arthroplasty. Clin Orthop1993; 288: 73–77.
20.
Andriacchi TP, Andersson GBJ, Fermier RW, Stern D, Galante JO. A Study of lower limb mechanics during stair-climbing. J Bone Joint Surg Am1980; 62A: 749–757.
21.
McFadyen BJ, Winter DA. An integrated biomechanical analysis of normal stair ascent and descent. J Biomech1988; 21: 733–744.
22.
Moffet H, Richards CL, Malouin F, Bravo G. Load-carrying during stair ascent: a demanding functional test. Gait Posture1993; 1: 35–44.
23.
Rodosky MW, Andriacchi TP, Andersson GB. The in‘uence of chair height on lower limb mechanics during rising. J Orthop Res1989; 7: 266–271.
24.
Schenkman M, Berger RA, Riley PO, Mann RW, Hodge WA. Whole-body movements during rising to standing from sitting. Phys Ther1990; 70: 638–648.
25.
Vander Linden DW, Brunt D, McCulloch MU. Variant and invariant characteristics of the sit-to-stand task in healthy elderly adults. Arch Phys Med Rehabil1994; 75: 653–660.
26.
Richards CL, Malouin F, Durand A, Moffet H. Muscle activation level comparisons for determining functional demands of locomotor tasks. Semin Orthop1989; 4: 120–129.
27.
Perron M, Malouin F, Moffet H et al. Altered weight transfer during double to single limb standing after total hip arthroplasty. Soc Neurosci1997; 23: Abstract 925.9.
