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ACL Reconstruction:

(Alcock et al, 2012; n = 25 participants after ACL surgery, with 10 women, in the test-retest reliability sample)

• SEM = 3.7 points

Various Lower Extremity Injuries:

(Binkley et al, 1999; n = 107 patients with hip, thigh, knee, leg, ankle and foot injuries)

• SEM = 3.9 points

Total Knee Anthroplasty and Total Hip Anthroplasty (TKA and THA):

(Stratford et al, 2000; n = 40 patients with TKA; n = 33 patients with THA)

• SEM = 3.7 points

Orthopaedic Rehab Ward:

(Young et al, 2009; n = 91 subjects with a primary complaint of neck pain and with or without concomitant upper extremity symptoms)

• SEM = 4 points

ACL Reconstruction:

(Alcock et al, 2012; n = 45 total participants after ACL surgery; 28 men, mean age = 29.4 years; 17 women, mean age = 29 years)

• MDC = 8.7 points

Various Lower Extremity Injuries:

(Binkley et al, 1999)

• MDC = 9 points

Hip Impairment:

(Wang et al, 2009; n = 8714 people who had hip impairments)

• MDC = 7 points or 11.3%

TKA and THA:

(Stratford et al, 2000)

• MDC = 9 points

Lower Extremity Injuries: (Abbott & Schmitt, 2014; n = 1062; mean age = 33.0 (16.5); age range = 9-91; 15-point patient-perceived global rating of change (GROC) assessed at discharge)

• MCID for LEFS (n = 539) at small change in GROC (11+ or "somewhat better") = 9
• MCID for LEFS (n = 539) at medium change in GROC (12+ or "moderately better") = 12
• MCID for LEFS (n = 539) at large change in GROC (12+ or "quite a bit better") = 16

ACL Reconstruction:

(Alcock et al, 2012)

• MCID = 9 points

Various Lower Extremity Injuries:

(Binkley et al, 1999)

• MCID = 9 points

Hip Impairment:

(Wang et al, 2009)

• MCID = 6 points or 11.3%

TKA and THA:

(Stratford et al, 2000)

• MCID = 9 points

ACL Reconstruction:

(Alcock et al, 2012)

• LEFS scores can be used to predict functional recovery after surgery with rapid improvements 7 to 8 weeks post with slower improvements after. Improvement adheres to bone and soft tissue healing as well as a regain of muscle inhibition secondary to decreased swelling and pain. An example of such a prediction would be at 16 weeks where the predicted LEFS score is 63 out of 80. It is speculated that further treatment could overcome any remaining deficits

ACL Reconstruction:

(Alcock et al, 2012)

• The mean (SD) LEFS scores for the test and retest assessments were 50.6 (11.6) and 51.0 (12.5)

Various Lower Extremity Injuries:

(Binkley et al, 1999)

• Excellent test-retest reliability for the entire sample (r = 0.86; 95% lower limit CI = 0.80), and for the subset of patients with more chronic conditions (r = 0.94; 95% lower limit CI = 0.89)

Total Knee Arthoplasty (TKA):

(Kennedy et al, 2008)

• Excellent test-retest reliability (intraclass correlation coefficient, type 2,1) for the LEFS derived from a sample of patients following arthroplasty (r = 0.85)

TKA and THA:

(Stratford et al, 2009)

• Excellent test-retest reliability (r = 0.85)

TKA/THA due to OA:

(Stratford et al, 2010)

• Excellent test-retest reliability for entire sample (r = 0.86), and more chronic conditions (r = 0.94)

Self Report/Performance Measures:

(Stratford et al, 2003; n = 93 total patients who are awaiting or received TKA or THA, mean age = 63.2 (11.3), 46 females and 47 males)

• Excellent test-retest reliability in sample-dependent range (r = 0.85 to 0.94)

ACL Reconstruction:

(Alcock et al, 2012)

• Excellent interrater reliability (ICC = .90)

Various Lower Extremity Injuries:

(Binkley et al, 1999)

• Excellent interrater reliability (r = 0.84)

TKA/THA due to OA:

(Stratford et al, 2010)

• Excellent interrater reliability (r = 0.84)

Ankle Fractures:

(Lin et al, 2009; n = 306 participants with ankle fracture were recruited within 7 days of cast removal)

• Excellent reliability coefficient at baseline (alpha = 0.92)
• Excellent reliability coefficient at short-term follow up (alpha = 0.94)
• Excellent reliability coefficient at long-term follow up (alpha = 0.90)

Hip impairments:

(Hart et al, 2005)

• Excellent reliability coefficient (alpha = 0.96)

Various Lower Extremity Injuries:

(Binkley et al, 1999)

• Excellent reliability coefficient (alpha = 0.96)

Predictive validity:

Lower Extremity Injuries: (Abbott & Schmitt, 2014)

• Adequate predictive validity of LEFS (n = 539) at small (GROC = 11+), medium (GROC = 12+) and large (GROC = 13+) levels of patient-perceived levels of change (AUC = 0.863 (0.790, 0.936), 0.849 (0.785, 0.912), 0.805 (0.752, 0.858), respectively)

Concurrent validity:

THA:

(Domzalski et al, 2010; n = 128 high functioning hip anthroplasty patients)

• The ASAP (Activity Scale for Arthroplasty Patients) demonstrated strong concurrent validity with the LEFS with both identified factors (activity, running and running related environments): The Pearson product correlation (concurrent validity) between the summated LEFS score was 0.77 (P < .01) for the activities factor of the ASAP and 0.31 (P < .01) for the running and running- related environment aspect of the ASAP

Ankle Fractures:

(Lin et al, 2009)

• Concurrent validity of the Lower Extremity Functional Scale was excellent compared with the Olerud Mo- lander Ankle Score at the short- and medium-term follow-ups (r = 0.80 and 0.87, respectively). The correlation with walking speed and stepping rate on stairs was moderate at the short-term follow-up (r = 0.61 and 0.63, respectively) but poor at the medium-term follow-up (r = 0.24 and 0.39, respectively)

Various Lower Extremity Injuries:

(Binkley et al, 1999)

• Excellent correlations between the LEFS scores and the SF-36 physical function subscale and physical component summary scores (r = 0.80; 95% lower limit CI=.73) and (r = 0.64; 95% lower limit CI = 0.54, respectively)
• Poor correlation between the LEFS scores and the SF-36 mental component summary scores (r = 0.30; 95% lower limit CI = 0.14)

THA:

(Domzalski et al, 2010)

• Excellent correlation between the ASAP AUC and LEFS AUC (r = 0.769 and r = 0.723)

Ankle Fractures:

(Lin et al, 2009)

• To assess construct validity, the variance in activity limitation explained by the Lower Extremity Functional Scale was analyzed using principal components analysis of the residuals generated by the Rasch analysis using WINSTEPS software. High construct validity of the Lower Extremity Functional Scale was demonstrated using Rasch analysis. At all time points, the scale explained a high variance in activity limitation. All items of the scale had a positive correlation with the overall scale

Self Report/Performance Measures:

(Stratford et al, 2003; n = 93 patients with osteoarthritis in hip or knee; mean age = 63.2 (11.3))

• Composite performance score based on time, pain, and exertion: 0.44 (composite timed score) to 0.59 (pooled domain and activity score) when correlating the LEFS with single and multiple activity domain scores.

TKA:

(Stratford et al, 2004; n = 102 patients with hip or knee osteoarthritis undergoing total joint replacement within 16 days or over 20 days after the first postoperative assessment)

Various Lower Extremity Injuries:

(Binkley et al, 1999)

• Excellent no ceiling or floor effect associated with the LEFS in this patient population

THA:

(Domzalski et al, 2010)

• Adequate when for every item, at least 88% of the participants selected either ¡°no difficulty¡± or ¡°a little bit of difficulty,¡± suggesting ceiling effects of the LEFS for this population. In many of the younger, more active patients this instrument failed to measure progressive patient report of improvements at 6 months to 1 year and beyond

Ankle Fractures:

(Lin et al, 2009)

• Excellent no participant scored the lowest possible score at baseline or follow up, indicating no floor effect
• Adequate the LEFS did not have a ceiling effect at short term follow up, but was close at medium-term follow up (14% scored the highest possible score, close to the 15% cut off)

Ankle Fractures:

(Lin et al, 2009)

• The LEFS was responsive in the short-term, but it is still uncertain whether it is in the medium term. Responsiveness in the medium term warrants further validation. Although the mean area under the ROC curve showed that the Lower Extremity Functional Scale had high external responsiveness, the 95% confidence interval included values below 0.70, suggesting uncertainty.

TKA:

(Stratford et al, 2004)

• Standardized Response Mean: Preoperative to first postoperative interval: -0.68 (n = 102). First postoperative to second postoperative interval: 1.62 (n = 102)
• Moderate effect size (first postoperative follow up = 0.73)
• Large effect size (second postoperative follow up = 1.76)

Hip Osteoarthritis (OA):

(Pua et al, 2009; n = 100 adults with symptomatic hip OA)

• SEM = 5.3 points

Orthopaedic Rehab Ward:

(Young et al, 2009; n = 91 subjects with a primary complaint of neck pain and with or without concomitant upper extremity symptoms)

• SEM = 4 points

Lower Extremity Osteoarthritis:

(Kennedy et al, 2007)

• MDC = 9 points

Hip Osteoarthritis:

(Pua et al, 2009)

• MDC = 9.9 points

Hip Osteoarthritis:

(Pua et al, 2009)

• Excellent test-retest reliability (r = 0.86)

Hip Osteoarthritis:

(Pua et al, 2009)

• Excellent interrater reliability (r = 0.84)

Hip Osteoarthritis:

(Pua et al, 2009)

• Excellent reliability coefficient (alpha = 0.92)

Hip Osteoarthritis:

(Pua et al, 2009)

• Pearson coefficients and one way analysis of variance, compared with SF-36, showed to be more sensitive to change

Stroke:

(Verheijde et al, 2013; n = 43 individuals receiving neurorehabilitation for lower extremity dysfunction after stroke; age range = 32 to 95 years; mean age = 70) Excellent test-retest reliability (ICC = 0.96)

Stroke:

(Verheijde et al, 2013)

• Adequate to Excellent correlation between the LEFS and the Short Form 36 Function Scale, Berg Balance Scale, Six Minute Walk Test, Five Meter Walk Test, Timed Up and Go Test, and the LAS of function (r = 0.40 - 0.71)

Stroke:

(Verheijde et al, 2013)

• From baseline to studies end increased 1.2 standard deviations

Orthopaedic Rehab Ward:

(Young et al, 2009; n = 91 subjects with a primary complaint of neck pain and with or without concomitant upper extremity symptoms)

• SEM = 4 points

Orthopaedic Rehab Ward:

(Young et al, 2009)

• Excellent test-retest reliability (ICC = 0.88)

Orthopaedic Rehab Ward:

(Yeung et al, 2009)

• The SRM of the LEFS from admission to discharge was 1.76 on patients rated as improved