To develop a comprehensive, valid, and reliable assessment tool that can be used across in-patients and out-patients, post orthopedic surgeries, which can track the recovery trajectory and determine the effectiveness of rehabilitation interventions for Indian culture.
After receiving ethics approval, a methodological study was initiated to develop the Post-orthopedic Surgery Recovery Status – India (POSRS-I) scale- English version. The study was registered in the trial registry of India (CTRI) The study began with an extensive literature review aimed at identifying potential gaps in existing post-operative recovery scales and determining their applicability to the Indian population. POSRS-I was generated, composed of three important areas, POSRS-I for in-patient department, out-patient department and pain assessment. It assesses various aspects on a Likert scale from one to five. Multiple rounds of feedback were obtained from an expert panelconsisting of experienced (6) physiotherapists and orthopedic surgeons. The pilot scale was tested on group of post-operative orthopedic patients (42) of upper limb (UL) and lower limb (LL) conditions in both in-ward and OPD to assess its clarity, feasibility, and patient responses. Reliability was tested for inter-rater and intra-rater measures using intra-class correlation coefficient (ICC), and validity using content validity index (CVI), item level(I-CVI) and scale level (S-CVI), Cronbach’s alpha (CA), SPSS v20 was used.
For validity, item-level CVI was 0.75-0.95, scale level CVI/ average was 0.82. Reliability for OPD UL (Intra-rater ICC= 0.983, CA= 0.991, Inter-rater ICC= 0.94, CA = 0.96), for OPD LL (Intra-rater ICC= 0.976, CA= 0.98, inter-rater ICC= 0.96, CA= 0.98). IPD UL (intra-rater ICC= 0.84, CA= 0.91, inter-rater ICC= 0.93, CA= 0.96) and for IPD LL (Intra-rater ICC= 0.83, CA= 0.84, inter-rater ICC= 0.81, CA= 0.89). Validity, including content and face validity, was confirmed through expert review, ensuring the scale comprehensively addresses critical aspects of recovery.
POSRS-I has been developed through a comprehensive process. Scale demonstrates excellent reliability and validity, making it a robust tool for assessing the recovery status of post-operative orthopedic patients in the Indian context. Its structured approach to evaluating key domains such as activities of daily living, mobility, balance, and pain ensures accurate and holistic patient assessment.
The POSRS-I scale has potential to significantly improve clinical decision-making in the rehabilitation of post-orthopedic surgery patients. By offering a standardized method, it can guide in personalized treatment plans, tracking patient progress. Its applicability to the Indian population fills a critical gap, offering clinicians a culturally relevant tool for patient care which can be further translated into local languages.
Post-operative recovery
Scale development
