Validity of Visual Assessment of Sit to Stand After Hip Fracture.
Cynthia Zablotny, Tiffany Hilton, Linda Riek and 3 others
PMID 29738404WHAT IT FOUND
Experienced home health physical therapists watched sit-to-stand videos and judged involved-leg force close enough to the measured value only 39% of the time.
They identified the leg producing less force 74% of the time.
Key findings
01Across the 10 videos, 18 therapists selected the involved limb correctly 74% of the time.
02Only 39% of therapist judgments of involved-limb force were within 7% of the measured value.
03Therapist force judgments were not significantly more accurate when symmetry was high, moderate, or low.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 18 therapists judged 10 videos, so the results may not reflect how all clinicians assess patients. Therapists viewed frontal-plane videotapes only, without sagittal views or real home-environment cues that could change accuracy. The task asked therapists to focus only on lower-limb force, while clinical assessments often involve multiple body systems, which may change accuracy. The 7% error threshold was based on non-injured controls and may have been too stringent. Knowing the side of fracture has limited clinical value because therapists usually learn it from the patient chart. The videos were selected from existing data to represent a range of force symmetry, not from a consecutive clinical sample. The therapists received a 30-minute training that is not routinely available to clinicians.
Declared interests
The authors declare no conflict of interest. The supplied publication types include NIH extramural research support.
The easy way to misread this
Do not treat visual sit-to-stand assessment as a valid way to measure leg force. The therapists identified the leg producing less force 74% of the time, but force estimates were close enough to the measured value only 39% of the time, and accuracy did not improve reliably across symmetry levels.