Determination of prefracture physical function in community-dwelling people who fracture their hip

Background, Prefracture physical function must be accurately determined to set appropriate and attainable goals for rehabilitation following hip fract ure. This is especially important for people who were living independently prior to their fracture. This study determines reliability and internal con sistency of a prefracture physical function questionnaire (PFPFQ) completed by both patients and knowledgeable informants (KIs). Methods. A 20-item PFPFQ, including ambulation, transfers, balance, and sel f-care domains, was developed using focus groups. Community-dwelling patien ts with a hip fracture (N = 40, 77.9 +/- 8 years) completed the PFPFQ on tw o occasions during postoperative acute care. Forty KIs were identified by t he patients and also completed the PFPFQ on two occasions via telephone int erview. Day-to-day reliability of the patients and KIs [intraclass correlat ion coefficients (ICC)], and internal consistency [Kuder-Richardson coeffic ient (KR)] of the PFPFQ were determined. Results. Intrarater reliability was high with ICCs (95% confidence interval ) of 0.94 (0.89, 0.96) for patients and 0.96 (0.93, 0.98) for KIs. Interrat er reliability on occasion 1 had an ICC of 0.81 (0.69, 0.88). Internal cons istency of the patient responses on the first occasion was high (KR coeffic ient = 0.896). Conclusions. The PFPFQ is a reliable and internally consistent instrument f or determining prefracture physical function in community-dwelling people w ho fracture their hip. In situations where patients with a hip fracture are unable to provide this necessary information, KIs can provide reliable est imates of prefracture function to assist in setting appropriate rehabilitat ion goals.