Harris Hip Score: Difference between revisions
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== Method of Use == | == Method of Use == | ||
No training is required to administer the HHS and it requires very little time to complete. There are ten items covering four domains. The domains are [[Pain Behaviours|pain]], function, absence of deformity, and [[Range of Motion|range of motion]]<ref name=":1" />. | No training is required to administer the HHS and it requires very little time or equipment (goniometer, plinth) to complete. There are ten items covering four domains. The domains are [[Pain Behaviours|pain]], function, absence of deformity, and [[Range of Motion|range of motion]]<ref name=":1" />. | ||
The pain domain measures pain severity and its effect on activities and need for [[Pain Medications|pain medication]]. The function domain is divided into [[ADL's|daily activities]] and [[gait]]. | The pain domain measures pain severity and its effect on activities and need for [[Pain Medications|pain medication]]. The function domain is divided into [[ADL's|daily activities]] and [[gait]]. The deformity domains observes hip flexion, adduction, internal rotation, and extremity length discrepancy while the range of motion domain asses hip ROM. | ||
The | The HHS is divided into three sections. The first section are questions about pain and its impact which are answered by the patient or client. The second and third sections require the physiotherapist to assess the patient or client's hip joint and function. | ||
The HHS is a measure of dysfunction so the higher the score, the better the outcome for the individual. Results can be recorded and calculated [https://www.orthopaedicscore.com/scorepages/harris_hip_score.html online]. The maximum score possible is 100. Results can be interpreted with the following<ref name=":0" />: <70 = poor result; 70–80 = fair, 80–90 = good, and 90–100 = excellent. | The HHS is a measure of dysfunction so the higher the score, the better the outcome for the individual. Results can be recorded and calculated [https://www.orthopaedicscore.com/scorepages/harris_hip_score.html online]. The maximum score possible is 100. Results can be interpreted with the following<ref name=":0" />: <70 = poor result; 70–80 = fair, 80–90 = good, and 90–100 = excellent. | ||
Revision as of 06:42, 21 June 2019
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Objective[edit | edit source]
The Harris Hip Scale (HHS) was developed for the assessment of the results of hip surgery, and is intended to evaluate various hip disabilities and methods of treatment in an adult population. The original version was published 1969[1]. The HHS is an outcome measure administered by a qualified health care professional, such as a physician or a physical therapist.
Intended Population[edit | edit source]
People with a total hip replacement (THR), femoral neck fractures or osteoarthritis[2].
Method of Use[edit | edit source]
No training is required to administer the HHS and it requires very little time or equipment (goniometer, plinth) to complete. There are ten items covering four domains. The domains are pain, function, absence of deformity, and range of motion[2].
The pain domain measures pain severity and its effect on activities and need for pain medication. The function domain is divided into daily activities and gait. The deformity domains observes hip flexion, adduction, internal rotation, and extremity length discrepancy while the range of motion domain asses hip ROM.
The HHS is divided into three sections. The first section are questions about pain and its impact which are answered by the patient or client. The second and third sections require the physiotherapist to assess the patient or client's hip joint and function.
The HHS is a measure of dysfunction so the higher the score, the better the outcome for the individual. Results can be recorded and calculated online. The maximum score possible is 100. Results can be interpreted with the following[1]: <70 = poor result; 70–80 = fair, 80–90 = good, and 90–100 = excellent.
Evidence[edit | edit source]
Reliability[edit | edit source]
Cronbach's alpha coefficient showed high internal consistency reliability except for deformity, which could not be calculated.
The test–retest interval was 3 to 4 weeks. The total score reliability was excellent for physicians (r = 0.94) and physiotherapists (r = 0.95). The physiotherapist and the orthopedic surgeon showed excellent test–retest reliability in the domains of pain (r = 0.93 and r = 0.98, respectively) and function (r = 0.95 and r = 0.93, respectively). The calculations were done with Pearson's and Spearman's correlation coefficients.
One study[3] reported the interrater correlations as good to excellent (0.74–1.0) for the domain scores, as did a study by Kirmit et al[4].
Validity[edit | edit source]
The HHS content validity has been tested by directly comparing HHS, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Short Form 36 (SF-36). No major differences between the scores were seen. The HHS construct validity was tested by comparing the pain and function domains in HHS, WOMAC, Nottingham Health Profile (NHP), and SF-36. The HHS domains pain and function correlated (Spearman's rho) better with similar domains in WOMAC, NHP, and SF-36 than with different domains. In another study, the same result was obtained when comparing HHS, WOMAC, and SF-36. Correlations (Kendall's tau) between HHS and SF-36 have been shown to be strong in the physical domains and weak in the mental domains. A strong correlation (Spearman's rho) has been found between HHS and NHP
Responsiveness[edit | edit source]
Wamper et al[5] report unacceptable ceiling effects in 31 of 59 studies. Pooled data across the studies included (n = 6,667 patients) suggested ceiling effects of 20% (95% confidence interval 18–22).
HHS responsiveness has been determined in a study of 335 THRs. The effect size between preoperative and 6-months postoperative was excellent for pain (2.80) and function (1.72), but weak in the 2-years followup, i.e., pain (0.15) and function (0.18). When comparing the HHS, Barthel Index, and EuroQol 5-domain (EQ-5D) in patients with femoral neck fractures 4 and 12 months after surgery, the standardized response mean was 0.75 for HHS, 0.40 for Barthel Index, and 0.46 for EQ-5D.
References[edit | edit source]
- ↑ 1.0 1.1 Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end‐result study using a new method of result evaluation. J Bone Joint Surg Am 1969; 51:737–55.
- ↑ 2.0 2.1 Nilsdotter A, Bremander A. Measures of hip function and symptoms: Harris Hip Score (HHS), Hip Disability and Osteoarthritis Outcome Score (HOOS), Oxford Hip Score (OHS), Lequesne Index of Severity for Osteoarthritis of the Hip (LISOH), and American Academy of Orthopedic Surgeons (AAOS) Hip and Knee Questionnaire. Arthritis Care Res. 2011. 63; S11 Supplement: Special Outcomes: S200-S207. Accessed 21 June 2019.
- ↑ Söderman P, Malchau H. Is the Harris hip score system useful to study the outcome of total hip replacement? Clin Orthop Relat Res. 2001 Mar;(384):189-97. Accessed 21 June 2019.
- ↑ Kirmit L, Karatosun V, Unver B, Bakirhan S, Sen A, Gocen Z. The reliability of hip scoring systems for total hip arthroplasty candidates: assessment by physical therapists. Clin Rehabil. 2005 Sep;19 (6):659-61. Accessed 21 June 2019.
- ↑ Wamper KE, Sierevelt IN, Poolman RW, Bhandari M, Haverkamp D. The Harris hip score: Do ceiling effects limit its usefulness in orthopedics? Acta Orthop. 2010 Dec;81 (6):703-7. Accessed 21 June 2019.
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