PREFRACTURE FUNCTION IN HIP FRACTURE
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that we excluded patients with cognitive impairments from
the study. It has been reported that poor cognitive status of
the patient and poorer physical status both tend to predict
low agreement (11), and the KIs in this study were less reli-
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portant to recognize that our results cannot be generalized to
the broader population of people who fracture their hip. It is
also important to further test the utility of the PFPFQ in a
wider sample of people who fracture their hip, including
people with lower function in institutions, and people at any
functional level who have cognitive deficits. It is in popula-
tions like these, where people may not be able to give accu-
rate information on their prefracture physical function, that
the PFPFQ, when completed by a KI, would have particular
value. Further, the ceiling effect noted in this study of com-
munity-dwelling people who fracture their hip would likely
be less evident in other hip fracture populations with lower
functional ability at the time of injury. However, the ten-
dency of KIs to be less reliable when judging patients of
lower function in this study may affect reliability and con-
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This study has shown that the PFPFQ is a reliable instru-
ment with good internal consistency for determining pre-
fracture physical function in community-dwelling people
who fracture their hip. Importantly, the PFPFQ is also user
friendly for clinicians, as both direct and telephone adminis-
tration take only between 5 to 10 minutes to complete. Fur-
thermore, we have shown that KIs can be used to provide
reliable and concurrently valid estimates of prefracture
physical function for community-dwelling patients with a
hip fracture. By providing reliable and consistent estimates
of prefracture physical function, the PFPFQ may be helpful
to those involved in the acute care and rehabilitation of
community-dwelling older people with hip fracture.
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Acknowledgments
This project was funded by the London Health Sciences Centre, Health
Services Research Fund. The authors would like to thank Karolyn Smith,
Guido Wisoztki, and Brenda Coleman for their assistance in data collection
with the knowledgeable informants. Preliminary reports of the data were
presented in abstract form at the American Physical Therapy Association
and Canadian Physiotherapy Association annual meetings in 1998.
Address correspondence to Tom Overend, PhD, BScPT, School of Phys-
ical Therapy, University of Western Ontario, London, ON, Canada N6G
1H1. E-mail: toverend@julian.uwo.ca
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and their caregivers. Age Ageing. 1997;26:99–106.
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Received October 8, 1999
Accepted January 10, 2000
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