Measurement properties of the tests recommended by the Osteoarthritis Research Society International

Background & Aims

The International Classification of Functioning, Disability, and Health (ICF) of the World Health Organization classifies challenges in walking, sit-to-stand, and stair negotiation as essential tasks for KOA patients. These challenges are classified as activity limitations. The OARSI suggests three fundamental performance-based tests: the 30-second chair stand test (30-s CST), the 4-by-10 m fast-paced walk test (40 m FPWT), and the stair climb test (SCT). The appropriate measurement properties of these tests are crucial, both in clinical and research settings. But the data that is currently available on these properties has not been thoroughly assessed, especially in populations that are seeking conservative treatment. In order to measure physical function in KOA patients, the purpose of this study is to evaluate the construct validity and responsiveness.

Methods

A prospective cohort study was conducted with KOA patients. The construct validity and responsiveness of the performance-based tests were assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. The KOA diagnosis criteria established by the American College of Rheumatology (ACR) were met by the participants. Baselines for data were acquired. During the first visit, functional tests were evaluated, and the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires were administered. Additionally, the activPALTM device was used. After seven days, the participants gave back the activPALTM. Six months after the second visit, participants were contacted for a follow-up visit. The Statistical Package for Social Sciences, version 21.0, was used for the analyses.

Results

To construct validity, 107 participants in total were included, and 80 for responsiveness analysis. It was possible to determine the construct validity using Spearman’s correlation coefficient. The 40m FPWT 7/9 (77.7%) and the 11-step SCT 7/9 (77.7%) both confirmed 75% of the predetermined hypotheses. The 30-second CST had a low construct validity score of 5/9 (55.5%). Regarding responsiveness, the 40m FPWT 6/6 (100%) and the 11-step SCT 6/6 (100%) confirmed 75% of the predefined hypotheses. The 30-second CST yielded a score of 2/6 (33.3%), indicating inadequate responsiveness in evaluating the shift in function.

Conclusions

The 40-m FPWT and the 11-step SCT showed strong construct validity and responsiveness, suggesting that those tests can detect changes over time, whereas the 30-s SCT demonstrated poor validity and responsiveness.

References

World Health Organization (2001) International Classification of Functioning, Disability and Health. World Health Organization, Geneva, Switzerland; Dobson, F., et al., (2013) OARSI recommended performance-based tests to assess physical function in people diagnosed with hip or knee osteoarthritis. Mokkink, LB., et al., (2010) The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study; Mokkink, LB., et al. COSMIN Risk of Bias checklist for systematic reviews of Patient-Reported Outcome Measures., R., et al., Development of criteria for the classification and reporting of osteoarthritis. Altman, R., et al., (1986) Development of criteria for the classification and reporting of osteoarthritis classification of osteoarthritis of the knee.

Presenting Author

Luiz Fernando Approbato Selistre

Poster Authors

Luiz Fernando Approbato Selistre

PhD

Department of Physiotherapy , Federal University of São Carlos, São Paulo, Brazil

Lead Author

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