Rasch Analysis of the 22 Knee Injury and Osteoarthritis Outcome Score–Physical Function Items in Italian Patients With Knee Osteoarthritis

2013 ◽  
Vol 94 (3) ◽  
pp. 480-487 ◽  
Author(s):  
Franco Franchignoni ◽  
Fausto Salaffi ◽  
Andrea Giordano ◽  
Marina Carotti ◽  
Alessandro Ciapetti ◽  
...  
2018 ◽  
Vol 43 (2) ◽  
pp. 140-147 ◽  
Author(s):  
Tariq A Kwaees ◽  
Jim Richards ◽  
Gill Rawlinson ◽  
Charalambos Panayiotou Charalambous ◽  
Ambreen Chohan

Background: Use of proprioceptive knee braces to control symptomology by altering neuromuscular control mechanisms has been shown in patellofemoral pain. Although their potential in patients with knee osteoarthritis is vast, little research has examined their efficacy. Objectives: This study examines the effect of a proprioceptive knee brace on lower limb kinematics and kinetics in healthy participants and in participants with OA. Methods: Thirteen healthy participants were asked to perform a 10-cm step-down task with and without a proprioceptive brace. Data were collected using a 10-camera Qualisys system. Individuals with osteoarthritis completed the Knee injury and Osteoarthritis Outcome Score before and after 4 weeks of intervention. Results: During step-down reductions in knee maximum internal rotation, transverse range of movement, transverse plane angular velocity and maximum internal rotation angular velocity was seen. Ankle plantar flexion and inversion angular velocity decreased while inversion and maximum supination angular velocity increased. Improvements in Knee injury and Osteoarthritis Outcome Score were noted across all parameters with brace use. Conclusion: Positive changes in kinematic variables in multiple planes can be achieved with proprioceptive bracing alongside improved patient outcome. These changes occur at the knee but analysis of other weight bearing joints should not be overlooked in future studies. This study supports the concept of neuromuscular reinforcement and re-education through proprioceptive bracing and its application in the management in knee osteoarthritis. Clinical relevance Proprioception can alter symptoms and biomechanics embraced and adjacent lower limb joints. The results of this study highlights the potential uses of non-mechanical bracing in the treatment of osteoarthritis and other potential to bridge the osteoarthritis treatment gap. Furthermore, large-scale research is needed to match disease subset to brace type.


Author(s):  
Saurabh P. Mehta ◽  
Joshua Jobes ◽  
Chloe Parsemain ◽  
Steve Lu ◽  
Kristie Kelley ◽  
...  

AbstractThe aim of this study was to verify the single-factor structure of the joint replacement version of the Knee Injury and Osteoarthritis Outcome Score (KOOS-JR) and examine its measurement properties in the context of Rasch analysis in patients with end-stage osteoarthritis of the knee (KOA) awaiting total knee replacement (TKR). The study design was retrieval of prospectively collected clinical data. The data were extracted from the presurgery visit for individuals with KOA who were scheduled for primary TKR at a tertiary care hospital. Those who were scheduled for revision of TKR had any other lower extremity injury or surgery during 6 months prior to the presurgery visit, or those who had reported pre-existing neurological impairments affecting the lower extremity functions were excluded during data extraction. The assumptions of Rasch analysis that were examined included the test of fit, fit of residuals, ordering of item thresholds, Pearson separation index, differential item functioning (DIF), dependency, and unidimensionality. The main outcome measure was KOOS-JR. Data were extracted for 283 patients, including 112 men and 160 women, from clinical charts. The KOOS-JR demonstrated good overall fit to the Rasch model. However, it failed to meet the assumption of unidimensionality. None of the items demonstrated DIF or concerns with response thresholds. Person–item threshold distribution indicated that the score for KOOS-JR overestimated person traits with floor and ceiling effects. Reliability statistics were equal to 0.9, suggesting that seven items within the KOOS-JR were internally consistent and reliable. The hypothetical unidimensional KOOS-JR could not be reproduced in our sample in that KOOS-JR had a latent construct. Future research should perform exploratory factor analysis to examine this latent construct.


2016 ◽  
Vol 43 (2) ◽  
pp. 395-404 ◽  
Author(s):  
Kathryn A.G. Mills ◽  
Justine M. Naylor ◽  
Jillian P. Eyles ◽  
Ewa M. Roos ◽  
David J. Hunter

Objective.To examine the influence of different analytical methods, baseline covariates, followup periods, and anchor questions when establishing a minimal important difference (MID) for individuals with knee osteoarthritis (OA). Second, to propose MID for improving and worsening on the Knee injury and Osteoarthritis Outcome Score (KOOS).Methods.Retrospective analysis of prospectively collected data from 272 patients with knee OA undergoing a multidisciplinary nonsurgical management strategy. The magnitude and rate of change as well as the influence of baseline covariates were examined for 5 KOOS subscales over 52 weeks. The MID for improving and worsening were investigated using 4 anchor-based methods.Results.Waitlisted for joint replacement and exhibiting unilateral/bilateral symptoms influenced change in KOOS over time. Generally, low correlations between anchors and KOOS change scores limited calculations of MID; thus, they were only proposed for the pain, activities of daily living, and quality of life subscales. The method used to calculate the MID influenced the cutpoint; however, the type of anchor question only influenced the MID when analyzed with a particular mean change method. Depending on patient and clinical characteristics, the subscale, and the analytical approach used, the MID for KOOS improvement ranged from an absolute change of −1.5 to 20.6 points and worsening ranged from −19.17 to 8.5 points.Conclusion.MID vary with patient and clinical characteristics, KOOS subscale, and analytical approach. Provided the anchor question is relevant to the patient-reported outcome and baseline status is considered, the anchor does not appear to influence the MID for improvement or worsening when using some anchor-based methods.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1745.2-1745
Author(s):  
A. Ben Tekaya ◽  
L. Rouached ◽  
A. Slimi ◽  
J. Galalou ◽  
E. Bahlouli ◽  
...  

Background:Overweight is a major risk factor for the development and progression of knee osteoarthritis (OA). Weight loss for patients with knee OA has been associated with improvement in self-reported pain and function and is recommended by EULAR as part of the therapeutic management.Objectives:The aim of the study was to evaluate the relation between overweight and functional impairment in adults with knee OA.Methods:It was a prospective study conducted in a rheumatologic department over a 4 months period. Patients with symptomatic knee OA based on the ACR criteria, were included. A screening of body mass index (BMI) was carried out for all patients. It was categorized following the WHO classification into: normal (<25 kg/m2), overweight (25 to <30), obese (up to 30).Pain level was evaluated using the Visual Analogue Scale (VAS). Function was assessed by the short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-PS) (KOOS-PS scores to 0 representing no difficulty and 100 representing extreme difficulty). The patients’ knee radiographies were graded according to Kellgren Lawrence criteria (KL). The patients were allocated in two groups; as grade I-II KL (Group 1) and grade III-IV KL (Group 2).Results:We included 143 patients with a mean age of 65.17± 10.7 years and 88.1% of women. Patients were from low socio-economic class in 30.8% of cases. Mean disease duration of the KOA was 5.4 years [3months-20 years] and mean BMI was 31.8±5.6kg/m2. Patients were with normal weight in 16.1%, overweight in 19.6% and obese in 64.3%.Knee OA was bilateral in 85.3% and other OA sites were associated in 37.8% of patients. Mean VAS pain of knee OA was 6.6±1.5 and KOOS-PS was 48.8±16.5/100. Concerning the radiographic damage; we found grade I-II (KL) in 22.6% and grade III-IV (KL) in 77.4%.High BMI (BMI≥25 kg/m2was not significantly associated with worse KOOS score (p=0.9), more pain (p=0.5) or an increasing severity of radiological knee osteoarthritis (p=0.14). Moreover, the level BMI was not associated with the presence of other OA sites (p=0.9) or a bilateral KOA (p=0.07).Conclusion:These data, from a subset of participants with symptomatic radiographic knee OA, demonstrate no correlation between obesity and pain, functional impairment and radiographic severity.Acknowledgments:noneDisclosure of Interests:None declared


2021 ◽  
pp. 026921552199798
Author(s):  
Vitor Ferreira ◽  
Leandro Machado ◽  
Adélio Vilaça ◽  
Francisco Xará-Leite ◽  
Paulo Roriz

Background: Lateral wedge insoles adjusted by biomechanical analysis may improve the condition of patients with medial knee osteoarthritis. Design: This is a prospective, randomized, controlled, single-blind clinical trial. Setting: The study was conducted in a biomechanics laboratory. Subjects: A total of 38 patients with medial knee osteoarthritis were allocated to either an experimental group (lateral wedge insoles) or a control group (neutral insoles). Interventions: Experimental group ( n = 20) received an adjusted lateral wedge insole of 2, 4, 6, 8, or 10 degrees, after previous biomechanical analysis. Control group ( n = 18) received a neutral insole (0 degrees). All patients used the insoles for 12 weeks. Main measures: Visual analogue scale, Knee Injury and Osteoarthritis Outcome Score questionnaire, biomechanical parameters: first and second peak of the external knee adduction moment and knee adduction angular impulse, and physical performance tests: 30-second sit-to-stand test, the 40-m fast-paced walk test, and the 12-step stair-climb test. Results: After 12 weeks, between-group differences did not differ significantly for pain intensity (−12.5 mm, (95% CI −29.4–4.4)), biomechanical parameters ( p = 0.05), Knee Injury and Osteoarthritis Outcome Score, and physical performance tests, except on the Knee Injury and Osteoarthritis Outcome Score subscale other symptoms ( p = 0.002; 13.8 points, (95% CI 5.6–22.0)). Conclusion: Tailored wedge insoles were no more effective at improving biomechanical or clinically meaningful outcomes than neutral insoles, except on symptoms. More participants from the experimental group reported they felt some improvement. However, these effects were minimal and without clinical significance.


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