Abstract：
Hip fractures are common and significantly impact mobility and physical function. Measurement of patient progress post hip fracture in the acute hospital setting is important to monitor early recovery and outcomes. The objective of this systematic review was to assess the measurement properties (reliability, validity, responsiveness), interpretability, and clinical utility of instruments used to measure mobility and physical function in patients with hip fracture in the acute hospital setting.
Three databases (MEDLINE, Embase, and CINAHL) were searched. Studies reporting direct clinician assessment instruments to measure mobility or physical function in patients with hip fracture were included. Data were extracted by 2 reviewers, and the quality of each study was determined using the COnsensus-based Standards for the selection of health Measurement INstruments risk of bias checklist.
Sixty-eight studies were included with 19 measurement instruments identified. The most frequently used instruments were the Timed \"Up & Go\" Test (TUG) (19 studies), Barthel Index (BI) (18 studies), Cumulated Ambulation Score (CAS) (18 studies), and Functional Independence Measure (FIM) (14 studies). All 4 of these instruments demonstrated good predictive validity (clinical outcomes and mortality) and responsiveness over time (effect sizes 0.63-2.79). The BI and CAS also had good reliability (intraclass correlation coefficient [ICC] >0.70). Floor effects were demonstrated for the TUG, CAS, and FIM (16%-60% of patients). The TUG, CAS, and BI all had good clinical utility.
Depending on the context (use by treating clinicians, research, benchmarking), 1 or a combination of the BI, CAS, and TUG provide robust measurement of mobility and physical function for patients with hip fracture in the acute hospital setting.
This study identified 3 instruments suitable for measuring mobility and physical function in hospitalized patients following hip fracture. This provides clinicians with tools to measure patient progress and benchmark across sites to improve patient outcomes.
Three databases (MEDLINE, Embase, and CINAHL) were searched. Studies reporting direct clinician assessment instruments to measure mobility or physical function in patients with hip fracture were included. Data were extracted by 2 reviewers, and the quality of each study was determined using the COnsensus-based Standards for the selection of health Measurement INstruments risk of bias checklist.
Sixty-eight studies were included with 19 measurement instruments identified. The most frequently used instruments were the Timed \"Up & Go\" Test (TUG) (19 studies), Barthel Index (BI) (18 studies), Cumulated Ambulation Score (CAS) (18 studies), and Functional Independence Measure (FIM) (14 studies). All 4 of these instruments demonstrated good predictive validity (clinical outcomes and mortality) and responsiveness over time (effect sizes 0.63-2.79). The BI and CAS also had good reliability (intraclass correlation coefficient [ICC] >0.70). Floor effects were demonstrated for the TUG, CAS, and FIM (16%-60% of patients). The TUG, CAS, and BI all had good clinical utility.
Depending on the context (use by treating clinicians, research, benchmarking), 1 or a combination of the BI, CAS, and TUG provide robust measurement of mobility and physical function for patients with hip fracture in the acute hospital setting.
This study identified 3 instruments suitable for measuring mobility and physical function in hospitalized patients following hip fracture. This provides clinicians with tools to measure patient progress and benchmark across sites to improve patient outcomes.
摘要：
目的：髋部骨折很常见，对活动和身体功能有显著影响。在急性医院环境中测量患者髋部骨折后的进展对于监测早期恢复和结果很重要。本系统综述的目的是评估测量特性(可靠性，有效性，响应能力)，可解释性,和临床实用的仪器用于测量髋部骨折患者的活动和身体功能在急性医院设置。
方法：三个数据库(MEDLINE，Embase,和CINAHL)进行了搜索。包括报告直接临床医生评估仪器以测量髋部骨折患者的活动性或身体功能的研究。由2名评审员提取数据，并使用基于CONSensus的健康测量指标（COSMIN）偏倚风险清单选择标准确定每个研究的质量。
结果：纳入了68项研究，确定了19种测量仪器。最常用的仪器是定时“Up&Go”测试(TUG)(19项研究)，Barthel指数（BI）（18项研究），累积步行评分（CAS）（18项研究），和功能独立性测量(FIM)(14项研究)。所有4种仪器都显示出良好的预测有效性（临床结果和死亡率）和随时间的响应性（效应大小0.63-2.79）。BI和CAS也具有良好的可靠性(ICC>0.70)。TUG的地板效应得到了证明，CAS和FIM（16％-60％的患者）。TUG,CAS和BI均具有良好的临床应用价值。
结论：根据具体情况（治疗临床医生使用，研究,基准测试)1或BI的组合，CAS,和TUG为急性医院环境中的髋部骨折患者提供了健壮的活动和身体功能测量。
结论：本研究确定了3种适用于测量髋部骨折后住院患者活动能力和身体功能的仪器。这为临床医生提供了跨站点测量患者进展和基准以改善患者结果的工具。
方法：三个数据库(MEDLINE，Embase,和CINAHL)进行了搜索。包括报告直接临床医生评估仪器以测量髋部骨折患者的活动性或身体功能的研究。由2名评审员提取数据，并使用基于CONSensus的健康测量指标（COSMIN）偏倚风险清单选择标准确定每个研究的质量。
结果：纳入了68项研究，确定了19种测量仪器。最常用的仪器是定时“Up&Go”测试(TUG)(19项研究)，Barthel指数（BI）（18项研究），累积步行评分（CAS）（18项研究），和功能独立性测量(FIM)(14项研究)。所有4种仪器都显示出良好的预测有效性（临床结果和死亡率）和随时间的响应性（效应大小0.63-2.79）。BI和CAS也具有良好的可靠性(ICC>0.70)。TUG的地板效应得到了证明，CAS和FIM（16％-60％的患者）。TUG,CAS和BI均具有良好的临床应用价值。
结论：根据具体情况（治疗临床医生使用，研究,基准测试)1或BI的组合，CAS,和TUG为急性医院环境中的髋部骨折患者提供了健壮的活动和身体功能测量。
结论：本研究确定了3种适用于测量髋部骨折后住院患者活动能力和身体功能的仪器。这为临床医生提供了跨站点测量患者进展和基准以改善患者结果的工具。
