Goal: To provide clinicians with recommendations of outcome measures appropriate for use along the continuum of care for patients before and after total joint arthroplasty (TJA).
Why: Despite recognizing the significant benefits of using outcome measures routinely for patients with TJA, PTs struggle with knowing which ones to use at different stages e.g. pre- and post–operatively. To address this need, the Total Joint Arthroplasty and Outcome Measures (TJAOM) Toolkit was developed and recently updated, by over 40 BC PT clinicians, students and researchers.
What: The TJAOM toolkit includes (1) interactive PDF summaries of recommended outcome measures (patient-reported and performance-based tests) appropriate for each phase of the TJA continuum (2) links to videos for performance-based tests (3) a discharge letter template with interpretation guide (4) a video providing information about outcome measurement concepts and clinical interpretation and (5) tables of ratings for all reviewed outcome measures.
Initially released in 2014 (TJAOM Toolkit 1.0), it was accessed provincially, nationally and internationally ~ 40,000 times and was awarded the Arthritis Health Professional Association Clinical Innovation Award in 2016.
TJAOM Toolkit 1.0 was updated in 2024 to reflect the current evidence
Acknowledgements
Profound appreciation to the teams responsible for this fabulous toolkit:
- TJAOM Toolkit 1.0 Team: Dr. Marie Westby, Ronda Field, Maureen Duggan, Dolores Langford, Robyn Laytham, Steven Longstaff, Phil Sweeney, Lauren Welch, Alison Hoens
- TJAOM Toolkit 2.0 Team: Dr. Marie Westby, Jane Burns, Melissa Idle, Clyde Smith, Aman Bajwa, Kelly Kavanagh, Jill Kipnis, Chiara Singh, Wing Ting Truong, Tony Hui, Paul Blazey, Jason Craig and Alison Hoens.
We also acknowledge the contributions of Dorothee Leesing and Stacy Wells in designing the toolkit and website.
All Outcome Measures
Patient reported outcome measures (PROMs) and Performance-based tests (PBTs) for patients waiting for or recovering from TKA (total knee or total hip arthroplasty)
| Name | Link | Description | Phase |
|---|---|---|---|
| 4 metre Walk Test (4mWT) | View Resource | Measures gait speed & functional mobility | Pre-op, Acute, Post-acute, Active living |
| 10 metre Walk Test (10mWT) | View Resource | Measures gait speed & functional mobility | Pre-op, Acute, Post-acute, Active living |
| 40 metre Fast-paced Walk Test (40mFPWT) | View Resource | Measures gait speed and functional mobility at fast pace | Pre-op, Post-acute, Active living |
| 6 Minute Walk Test (6MWT) | View Resource | Measures submaximal aerobic capacity & ability to walk over longer distances | Pre-op, Post-acute, Active living |
| 30 second Chair Stand Test (30sCST) | View Resource | Measures lower limb function, dynamic balance & strength | Pre-op, Post-acute, Active living |
| Berg Balance Scale (BBS) | View Resource | Measures static & dynamic balance | Pre-op, Post-acute, Active living |
| Balance Evaluation Systems Test (BESTest) | View Resource | Measures dynamic balance, functional mobility & gait | Pre-op, Post-acute, Active living |
| Brief Balance Evaluation Systems Test (Brief-BESTest) | View Resource | Measures dynamic balance, functional mobility & gait | Pre-op, Post-acute, Active living |
| Mini Balance Evaluation Systems Test (Mini-BESTest) | View Resource | Measures dynamic balance, functional mobility & gait | Pre-op, Post-acute, Active living |
| EuroQoL-5D-5L (EQ-5D-5L) | View Resource | Generic measure of health status based on 5 dimensions of health including mobility, self-care & pain | Pre-op, Post-acute, Active living |
| Forgotten Joint Score-12 (FJS-12) | View Resource | Measures self-efficacy & lower extremity function | Post-acute, Active living |
| Four Square Step Test (FSST, 4SST) | View Resource | Measures dynamic balance | Pre-op, Acute, Post-acute, Active living |
| Functional Reach Test (FRT) | View Resource | Measures static balance | Pre-op, Post-acute, Active living |
| Hip disability and Osteoarthritis Outcome Score (HOOS) | View Resource | Measures pain, other symptoms, function in daily living, sport and recreation & HRQoL | Pre-op, Post-acute, Active living |
| Hip disability and Osteoarthritis Outcome Score – Joint Replacement (HOOS-JR) | View Resource | Measures pain & function/daily living after THA | Pre-op, Post-acute, Active living |
| Knee injury and Osteoarthritis Outcome Score (KOOS) | View Resource | Measures pain, symptoms, function in daily living, sport and recreation & HRQoL | Pre-op, Post-acute, Active living |
| Knee injury and Osteoarthritis Outcome Score – Joint Replacement (KOOS-JR) | View Resource | Measures stiffness, pain & ADL after TKA | Pre-op, Post-acute, Active living |
| Lower Extremity Functional Scale (LEFS) | View Resource | Measures current ability to do common activities at home, work, school, recreation & sport | Pre-op, Post-acute, Active living |
| Numeric Pain Rating Scale (NPRS) | View Resource | Measures pain intensity at rest or with activity | Pre-op, Acute, Post-acute, Active living |
| Oxford Knee Score (OKS) | View Resource | Measures pain & function in relation to daily activities | Pre-op, Post-acute, Active living |
| Oxford Hip Score (OHS) | View Resource | Measures pain & function in relation to daily activities | Pre-op, Post-acute, Active living |
| Patient Specific Functional Scale (PSFS) | View Resource | Measures difficulty of 3 self-selected activities that the patient identifies as important | Pre-op, Acute, Post-acute, Active living |
| Pain Visual Analogue Scale (Pain VAS) | View Resource | Measures pain intensity at rest or with activity | Pre-op, Acute, Post-acute, Active living |
| Single Leg Stance (SLS) | View Resource | Measures static balance | Pre-op, Post-acute, Active living |
| Stair Climb Test (SCT) | View Resource | Measures functional strength, dynamic balance & agility | Pre-op, Post-acute, Active living |
| Step Test (ST) | View Resource | Measures lower extremity function, dynamic balance & proprioception | Pre-op, Post-acute, Active living |
| Timed Up and Go (TUG, TUAG) | View Resource | Measures strength, agility, mobility, dynamic balance & gait | Pre-op, Acute, Post-acute, Active living |
Knee PROMs
Patient reported outcome measures (PROMs) for patients waiting for or recovering from TKA (total knee arthroplasty)
| Name | Link | Description | Phase |
|---|---|---|---|
| EuroQoL-5D-5L (EQ-5D-5L) | View Resource | Generic measure of health status based on 5 dimensions of health including mobility, self-care & pain | Pre-op, Post-acute, Active living |
| Forgotten Joint Score-12 (FJS-12) | View Resource | Measures self-efficacy & lower extremity function | Post-acute, Active living |
| Knee injury and Osteoarthritis Outcome Score (KOOS) | View Resource | Measures pain, symptoms, function in daily living, sport and recreation & HRQoL | Pre-op, Post-acute, Active living |
| Knee injury and Osteoarthritis Outcome Score – Joint Replacement (KOOS-JR) | View Resource | Measures stiffness, pain & ADL after TKA | Pre-op, Post-acute, Active living |
| Lower Extremity Functional Scale (LEFS) | View Resource | Measures current ability to do common activities at home, work, school, recreation & sport | Pre-op, Post-acute, Active living |
| Numeric Pain Rating Scale (NPRS) | View Resource | Measures pain intensity at rest or with activity | Pre-op, Acute, Post-acute, Active living |
| Oxford Knee Score (OKS) | View Resource | Measures pain & function in relation to daily activities | Pre-op, Post-acute, Active living |
| Pain Visual Analogue Scale (Pain VAS) | View Resource | Measures pain intensity at rest or with activity | Pre-op, Acute, Post-acute, Active living |
| Patient Specific Functional Scale (PSFS) | View Resource | Measures difficulty of 3 self-selected activities that the patient identifies as important | Pre-op, Acute, Post-acute, Active living |
Knee PBTs
Performance-based tests (PBTs) for patients waiting for or recovering from TKA (total knee arthroplasty)
| Name | Link | Description | Phase |
|---|---|---|---|
| 4 metre Walk Test (4mWT) | View Resource | Measures gait speed & functional mobility | Pre-op, Acute, Post-acute, Active living |
| 10 metre Walk Test (10mWT) | View Resource | Measures gait speed & functional mobility | Pre-op, Acute, Post-acute, Active living |
| 40 metre Fast-paced Walk Test (40mFPWT) | View Resource | Measures gait speed and functional mobility at fast pace | Pre-op, Post-acute, Active living |
| 6 Minute Walk Test (6MWT) | View Resource | Measures submaximal aerobic capacity & ability to walk over longer distances | Pre-op, Post-acute, Active living |
| 30 second Chair Stand Test (30sCST) | View Resource | Measures lower limb function, dynamic balance & strength | Pre-op, Post-acute, Active living |
| Balance Evaluation Systems Test (BESTest) | View Resource | Measures dynamic balance, functional mobility & gait | Pre-op, Post-acute, Active living |
| Brief Balance Evaluation Systems Test (Brief-BESTest) | View Resource | Measures dynamic balance, functional mobility & gait | Pre-op, Post-acute, Active living |
| Mini Balance Evaluation Systems Test (Mini-BESTest) | View Resource | Measures dynamic balance, functional mobility & gait | Pre-op, Post-acute, Active living |
| Berg Balance Scale (BBS) | View Resource | Measures static & dynamic balance | Pre-op, Post-acute, Active living |
| Four Square Step Test (FSST, 4SST) | View Resource | Measures dynamic balance | Pre-op, Acute, Post-acute, Active living |
| Functional Reach Test (FRT) | View Resource | Measures static balance | Pre-op, Post-acute, Active living |
| Single Leg Stance (SLS) | View Resource | Measures static balance | Pre-op, Post-acute, Active living |
| Stair Climb Test (SCT) | View Resource | Measures functional strength, dynamic balance & agility | Pre-op, Post-acute, Active living |
| Step Test (ST) | View Resource | Measures lower extremity function, dynamic balance & proprioception | Pre-op, Post-acute, Active living |
| Timed Up and Go (TUG, TUAG) | View Resource | Measures strength, agility, mobility, dynamic balance & gait | Pre-op, Acute, Post-acute, Active living |
Hip PROMs
Patient reported outcome measures (PROMs) for patients waiting for or recovering from THA (total hip arthroplasty)
| Name | Link | Description | Phase |
|---|---|---|---|
| EuroQoL-5D-5L (EQ-5D-5L) | View Resource | Generic measure of health status based on 5 dimensions of health including mobility, self-care & pain | Pre-op, Post-acute, Active living |
| Forgotten Joint Score-12 (FJS-12) | View Resource | Measures self-efficacy & lower extremity function | Post-acute, Active living |
| Hip disability and Osteoarthritis Outcome Score (HOOS) | View Resource | Measures pain, other symptoms, function in daily living, sport and recreation & HRQoL | Pre-op, Post-acute, Active living |
| Hip disability and Osteoarthritis Outcome Score – Joint Replacement (HOOS-JR) | View Resource | Measures pain & function/daily living after THA | Pre-op, Post-acute, Active living |
| Lower Extremity Functional Scale (LEFS) | View Resource | Measures current ability to do common activities at home, work, school, recreation & sport | Pre-op, Post-acute, Active living |
| Numeric Pain Rating Scale (NPRS) | View Resource | Measures pain intensity at rest or with activity | Pre-op, Acute, Post-acute, Active living |
| Oxford Hip Score (OHS) | View Resource | Measures pain & function in relation to daily activities | Pre-op, Post-acute, Active living |
| Patient Specific Functional Scale (PSFS) | View Resource | Measures difficulty of 3 self-selected activities that the patient identifies as important | Pre-op, Acute, Post-acute, Active living |
| Pain Visual Analogue Scale (Pain VAS) | View Resource | Measures pain intensity at rest or with activity | Pre-op, Acute, Post-acute, Active living |
Hip PBTs
Performance-based tests (PBTs) for patients waiting for or recovering from THA (total hip arthroplasty)
| Name | Link | Description | Phase |
|---|---|---|---|
| 4 metre Walk Test (4mWT) | View Resource | Measures gait speed & functional mobility | Pre-op, Acute, Post-acute, Active living |
| 10 metre Walk Test (10mWT) | View Resource | Measures gait speed & functional mobility | Pre-op, Acute, Post-acute, Active living |
| 40 metre Fast-paced Walk Test (40mFPWT) | View Resource | Measures gait speed and functional mobility at fast pace | Pre-op, Post-acute, Active living |
| 6 Minute Walk Test (6MWT) | View Resource | Measures submaximal aerobic capacity & ability to walk over longer distances | Pre-op, Post-acute, Active living |
| 30 second Chair Stand Test (30sCST) | View Resource | Measures lower limb function, dynamic balance & strength | Pre-op, Post-acute, Active living |
| Balance Evaluation Systems Test (BESTest) | View Resource | Measures dynamic balance, functional mobility & gait | Pre-op, Post-acute, Active living |
| Brief Balance Evaluation Systems Test (Brief-BESTest) | View Resource | Measures dynamic balance, functional mobility & gait | Pre-op, Post-acute, Active living |
| Mini Balance Evaluation Systems Test (Mini-BESTest) | View Resource | Measures dynamic balance, functional mobility & gait | Pre-op, Post-acute, Active living |
| Berg Balance Scale (BBS) | View Resource | Measures static & dynamic balance | Pre-op, Post-acute, Active living |
| Four Square Step Test (FSST, 4SST) | View Resource | Measures dynamic balance | Pre-op, Acute, Post-acute, Active living |
| Functional Reach Test (FRT) | View Resource | Measures static balance | Pre-op, Post-acute, Active living |
| Single Leg Stance (SLS) | View Resource | Measures static balance | Pre-op, Post-acute, Active living |
| Stair Climb Test (SCT) | View Resource | Measures functional strength, dynamic balance & agility | Pre-op, Post-acute, Active living |
| Step Test (ST) | View Resource | Measures lower extremity function, dynamic balance & proprioception | Pre-op, Post-acute, Active living |
| Timed Up and Go (TUG, TUAG) | View Resource | Measures strength, agility, mobility, dynamic balance & gait | Pre-op, Acute, Post-acute, Active living |
Other supporting resources
The information provided within this toolkit is not intended to replace the clinical judgement of a health care professional to make a treatment decision regarding a patient. It is intended to be used as a tool to support clinicians and does not confer any educational qualification or certification.