The Lower Extremity Gain Scale: a performance-based measure to assess recovery after hip fracture

Abstract

Objective: To develop and determine the reliability and validity of a sensitive observational measure to assess recovery in clinically meaningful areas of function after hip fracture.

Design: Used survey data to identify activities difficult to perform after fracture; conducted focus groups; interviewed patients; and developed a standardized protocol to prospectively test the highest ranking activities.

Setting: Evaluations conducted in 8 Baltimore hospitals or the patients' residence.

Participants: Patients 2 to 24 months postfracture, 65 years and older, and community-dwelling.

Interventions: Not applicable.

Main outcome measure: The Lower Extremity Gain Scale (LEGS).

Results: Nine performance-based activities were appropriate for administration in clinical and research settings: (1) walk 3m (10ft); put on a (2) sock and (3) shoe on the fractured side; (4) rise from an armless chair; step (5) up and (6) down 4 stairs; get (7) on and (8) off the toilet; and (9) reach for an item on the ground from a sitting position. Reproducibility is good and measures of internal consistency and content, concurrent, and construct validity are high.

Conclusions: The LEGS can be easily administered by clinicians in a short time as part of care. Research and clinical scoring methods and performance norms can track recovery in activities that are most relevant in the lives of patients.