Transcultural adaptation and testing of psychometric properties of the Korean version of the Hip Disability and Osteoarthritis Outcome Score (HOOS)

Long-term follow-up of inpatients with traumatic fractures who received integrative Korean Medicine treatment: A retrospective analysis and questionnaire survey study

Previous studies have reported pain reduction after Korean medicine (KM) treatment in patients with fractures. However, these studies were limited by small sample sizes and short observation periods. To address these limitations, we aimed to analyze the outcomes of patients with traumatic fractures who received integrative KM treatment and investigate their long-term progress through follow-up observations. This study was a retrospective analysis and questionnaire survey conducted at a multi-center inpatient care setting in Korea. A total of 1150 patients who had traumatic fractures and received at least 5-day inpatient care at one of 5 KM hospitals. Finally, 339 patients completed the follow-up survey. The questionnaire survey was administered 3 months post discharge. The primary outcome was the difference in numeric rating scale (NRS) scores at admission and discharge for fracture-related pain. The secondary outcomes were EuroQol 5-Dimension 5-Level (EQ-5D-5L) score, Oswestry Disability Index, Neck Disability Index, Western Ontario and McMaster Universities Arthritis Index, Shoulder Pain and Disability Index, and Patient Global Impression of Change (PGIC) score. The follow-up questionnaire survey included questions on surgery and imaging before admission and after discharge and treatment within the past 3 months. The mean NRS score at follow-up showed a significant decrease of 4.41 points compared with that at admission (P < .001). The mean EQ-5D-5L score at follow-up showed a significant increase of 0.18 points compared with that at admission (P < .05). In the follow-up survey on PGIC, 307 participants (90.56%) were "minimally improved" or better. Integrative KM treatment can help improve pain, functional impairment, and long-term quality of life in patients with traumatic fractures.

Cross-Culturally Adapted Versions of Patient Reported Outcome Measures for the Lower Extremity

Background

A large number of patient reported outcome measures (PROMs) have been developed in the English language for various lower extremity orthopaedic pathologies. Twenty different PROMs were recommended for 15 specific musculoskeletal lower extremity pathologies or surgeries. However, the availability of cross-culturally adapted versions of these recommended PROMs is unknown.

Purpose

The purpose of this study was to identify the cross-culturally adapted versions of recommended PROMs for individuals experiencing orthopedic lower extremity pathologies or undergoing surgeries, and to identify the psychometric evidence that supports their utilization.

Study design

Literature Review.

Methods

PubMed, Embase, Medline, Cochrane, CINAHL, SPORTDisucs and Scopus were searched for cross-culturally adapted translated studies through May 2022. The search strategy included the names of the 20 recommended PROMs from previous umbrella review along with the following terms: reliability, validity, responsiveness, psychometric properties and cross-cultural adaptation. Studies that presented a non-English language version of the PROM with evidence in at least one psychometric property to support its use were included. Two authors independently evaluated the studies for inclusion and independently extracted data.

Results

Nineteen PROMS had cross-culturally adapted and translated language versions. The KOOS, WOMAC, ACL-RSL, FAAM, ATRS, HOOS, OHS, MOXFQ and OKS were available in over 10 different language versions. Turkish, Dutch, German, Chinese and French were the most common languages, with each language having more than 10 PROMs with psychometric properties supporting their use. The WOMAC and KOOS were both available in 10 languages and had all three psychometric properties of reliability, validity, and responsiveness supporting their use.

Conclusion

Nineteen of the 20 recommended instruments were available in multiple languages. The PROM most frequently cross-culturally adapted and translated were the KOOS and WOMAC. PROMs were most frequently cross-culturally adapted and translated into Turkish. International researchers and clinicians may use this information to more consistently implement PROMs with the most appropriate psychometric evidence available to support their use.

Level of evidence

3a.

Correlation of Patient-Reported Outcomes After Periacetabular Osteotomy With Femoral Head Coverage and Acetabular Orientation: A Single-Center Cohort Study

BACKGROUND

Gaining a better understanding of the underlying pattern of acetabular dysplasia 3-dimensionally can help better guide treatment and optimize clinical outcomes after periacetabular osteotomy (PAO).

PURPOSE

(1) To examine the relationship between femoral head coverage before and after PAO for dysplasia and patient-reported outcome measure (PROM) scores and (2) to assess if the direction/orientation of correction of the acetabulum can be predicted based on the Ottawa classification.

STUDY DESIGN

Cohort study; Level of evidence, 3.

METHODS

A retrospective analysis of a prospectively collected database from a single-center institutional registry of PAO was conducted, and PROM scores at a minimum of 2 years were analyzed. A total of 79 hips (67 patients [56 female]; mean age at surgery, 27.5 years [range, 15.8-53.7 years]) were available for inclusion. According to the Ottawa classification, 54 hips (68.4%) had global deficiency, 15 hips (18.9%) had posterior deficiency, and 10 hips (12.7%) had anterior deficiency. Hip2Norm software was used to analyze the 3-dimensional coverage of the femoral head. Statistical analysis was conducted to look at significant predictors of improvements in PROMs using the minimal clinically important difference (MCID) for the Hip disability and Osteoarthritis Outcome Score (HOOS) Activities of Daily Living subscale.

RESULTS

At a mean follow-up of 3.1 years (range, 2.0-7.4 years), all functional outcome scores improved significantly. A postoperative total femoral coverage <75.7%, posterior coverage (PC) <45.2%, and femoral head extrusion index >15.5% were all associated with not reaching the MCID for the HOOS Activities of Daily Living subscale. Multivariate analysis showed that PC was the single most important significant modifier influencing functional outcomes after PAO for the treatment of acetabular dysplasia, with an odds ratio of 6.0 (95% CI, 1.8-20.4; P = .004). One-way analysis of variance showed a significant difference comparing the mean change in radiographic measurements, that is, anterior coverage, PC, and total femoral coverage, per the Ottawa classification (P < .001).

CONCLUSION

Our study demonstrated that postoperative femoral head coverage and acetabular orientation were significant predictors of PROM scores. Classifying acetabular dysplasia into 3 groups based on the plane of instability could optimize the planning of PAO by giving a better understanding of the 3-dimensional deformity.

Cross-cultural adaptation and psychometric validation of the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire in French

BACKGROUND

The revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire allows capture of the beliefs and attitudes of older adults and caregivers towards deprescribing.

OBJECTIVES

To translate and validate the rPATD questionnaire into French.

METHODS

The French rPATD was translated using forward-backward translation. Psychometric properties were evaluated in both older adults ≥65 years living in the community or in institutions and who were taking at least one chronic medication and in caregivers of older adults with similar characteristics. Participants were recruited in four French-speaking countries (Belgium, Canada, France and Switzerland). Face and content validity were assessed during the translation process. Construct validity (exploratory factor analysis (EFA)) and internal consistency (Cronbach's alpha) were investigated in questionnaires without missing data. Test-retest reliability was evaluated using intra-class correlation coefficient (ICC) in a sample of participants.

RESULTS

In total, 320 questionnaires from older adults and 215 questionnaires from caregivers were included to evaluate construct validity and internal consistency. EFA extracted four factors in the older adults' and caregivers' versions of the questionnaire consistent with the English rPATD. The extracted factors related to the perceived burden of medication taking, the beliefs in appropriateness of medications, concerns about stopping medications and the level of involvement in making decisions and of knowledge of medications. Internal consistency was satisfactory for three factors for both versions (Cronbach's alpha >0.70), with lower internal consistency in the concerns about stopping factor. Test-retest reliability was overall good for all factors in the caregivers' version (ICC > 0.75) while for the older adults' version, moderate (ICC range: 0.75-0.50) to good ICC values were found.

CONCLUSIONS

The French rPATD presents globally good psychometric properties and can be used to explore attitudes towards deprescribing in French-speaking older adults and caregivers.

Polish adaptation and validation of the hip disability and osteoarthritis outcome score (HOOS) in osteoarthritis patients undergoing total hip replacement

BACKGROUND

The Hip disability and Osteoarthritis Outcome Score (HOOS) is a frequently used patient-reported outcome measure (PROM) for assessment of hip disorders and treatment effects following hip surgery. The objective of the study was to translate and adapt the Hip disability and Osteoarthritis Outcome Score (HOOS) into Polish and to investigate the psychometric properties of the HOOS in patients with osteoarthritis undergoing total hip replacement (THR).

MATERIALS AND METHODS

The Polish version of the HOOS was developed according to current guidelines. Patients completed the HOOS, Short Form 36 Health Survey (SF-36), the visual analogue scale (VAS) for pain and the global perceived effect (GPE) scale. Psychometric properties including interpretability (floor/ceiling effects), internal consistency (Cronbach's alpha), test-retest reliability (intra-class correlation coefficient, ICC), convergent construct validity (a priori hypothesized Spearman's correlations between the HOOS subscales, the generic SF-36 measure and the VAS for pain) and responsiveness (effect size, association between the HOOS and GPE scores) were analyzed.

RESULTS

The study included 157 patients (mean age 66.8 years, 54% women). Floor effects were found prior to THR for the HOOS subscales Sports and Recreation and Quality of Life. The Cronbach's alpha was over 0.7 for all subscales indicating satisfactory internal consistency. The test-retest reliability was good for the HOOS subscale Pain (0.82) and excellent for all other subscales with ICCs ranging from 0.91 to 0.96. The minimal detectable change ranged from 12.0 to 26.2 on an individual level and from 1.4 to 3.0 on a group level. Seven out of eight a priori hypotheses were confirmed indicating good construct validity. Responsiveness was high since the expected pattern of effect sizes in all subscales was found.

CONCLUSIONS

The Polish version of the HOOS demonstrated good reliability, validity and responsiveness for use in patient groups having THR.

Translation, Cross-Cultural Adaptation, and Psychometric Properties of the Polish Version of the Hip Disability and Osteoarthritis Outcome Score (HOOS)

Background and Objectives: This study aimed to translate the Hip disability and Osteoarthritis Outcome Score (HOOS) into the Polish language, to determine its validity and reliability, and to assess its main psychometric properties. Materials and Methods: A total of 332 hip osteoarthritis (OA) subjects were recruited to the study group and 90 healthy subjects to the control group. The study consisted of the HOOS translation and the assessment of the discriminative power, internal consistency, and the potential floor and ceiling effects followed by the determination of the construct validity and test-retest reliability. The analysis was performed using Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and SF-36 questionnaires. Results: The translation process consisted of forward translation, reconciliation, backward translation, review, harmonization, and proofreading. The hip OA patients reported a reduced HOOS score when compared to the control subjects. The discriminant validity of the questionnaire was confirmed. A Cronbach’s alpha of 0.97 was found, indicating a high internal consistency. The HOOS showed a significant correlation with the SF-36 and WOMAC, which ranged from r = −0.93, p-value < 0.05 for WOMAC total score to r = 0.92, and p-value < 0.05 for WOMAC daily living. No floor or ceiling effects were found. A very high intraclass correlation coefficient (ICC) was found (0.93–0.97) for the total score and the individual domains of the HOOS. Conclusions: The Polish HOOS is valid and reliable for evaluating the outcomes of hip OA patients in Poland. This questionnaire may be used with confidence for clinical and research purposes.

Transcultural adaptation and psychometric properties of the Korean version of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41)

We translated and adapted transculturally the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41) for Korean patients. The translated Korean version of QUALEFFO-41 showed satisfactory reliability and validity.

PURPOSE

The aim of this study was to translate the QUALEFFO-41 for Korean patients and then validate the Korean version of QUALEFFO-41.

METHODS

Translation and transcultural adaptation of the QUALEFFO-41 was conducted according to the international recommendations. Ninety-seven patients (mean age, 73.6 years) with osteoporosis were participated in validating the Korean version of QUALEFFO-41. To test reliability, internal consistency was evaluated using Cronbach's alpha coefficient. To test validity, convergent validity was assessed using correlation with the SF-12 and EQ-5D and discriminant validity was assessed using ROC curve analysis.

RESULTS

The English version of QUALEFFO-41 was translated and adapted to Korean without notable discrepancies. The Korean QUALEFFO-41 had good reliability with Cronbach's alpha ranging from 0.733 to 0.942. QUALEFFO-41 had good correlations to SF-12 and EQ-5D. Compared with subjects without history of vertebral fracture (VF), those with history of VF showed significantly worse scores according to QUALEFFO-41, but not according to SF-12 or EQ-5D. ROC curve analysis revealed that the physical function domain of QUALEFFO-41 had significant ability to discriminate between subjects with and without history of VF, while SF-12 or EQ-5D did not.

CONCLUSIONS

The Korean version of QUALEFFO-41 demonstrated relevant internal consistency, convergent validity, and discriminant validity, which can be recommended to evaluate quality of life in Koreans.

Hip Disability and Osteoarthritis Outcome Score (HOOS): A Cross-Cultural Validation of the Brazilian Portuguese Version Study

Objective  Translated and validated outcome instruments are of great importance, since they can be used for researchers studying different populations with the same problem. The objective of the present study was to translate, culturally adapt and validate the Hip Disability and Osteoarthritis Outcome Score (HOOS) into Brazilian Portuguese.

Methods  The HOOS was translated from English into Brazilian Portuguese, translated back into English, and submitted to an experts committee. It was administered to 100 patients with hip osteoarthritis. The psychometric evaluation included factor analysis; internal reliability measures, test-retest reliability at 7 days, and construct validity comparison with the Brazilian version of the Graded Chronic Pain Scale (GCPS).

Results  Factor analyses demonstrated a five-factor solution. The test-retest reliability showed a high degree of internal consistency for the five subscales ( pain and physical difficulties , 0.97 at baseline and 0.93 at 7 days; pain and difficulty sitting, lying down and getting up , 0.93 at baseline and 0.89 at 7 days; difficulty flexing the knee , 0.92 at baseline and 0.83 at 7 days; difficulty walking , 0.88 at baseline and 0.87 at 7 days; quality of life , 0.80 at baseline and 0.35 at 7 days). The construct validity was established during the comparison of the Brazilian version of the GCPS.

Conclusions  A Brazilian version of the HOOS was developed with adequate reliability and validity. It will facilitate evaluation of the hip within a large patient population and across cultures.

Item selection for 12-item short forms of the Knee injury and Osteoarthritis Outcome Score (KOOS-12) and Hip disability and Osteoarthritis Outcome Score (HOOS-12)

OBJECTIVE

To develop 12-item short forms (KOOS-12, HOOS-12) of the 42-item Knee injury and Osteoarthritis Outcome Score (KOOS) and 40-item Hip disability and Osteoarthritis Outcome Score (HOOS) that represent the full-length instruments sufficiently to provide joint-specific pain, function and quality of life (QOL) domain and summary joint impact scores. This paper describes KOOS-12 and HOOS-12 item selection. Subsequent papers will examine KOOS-12 and HOOS-12 reliability, validity and responsiveness.

DESIGN

Items were selected based on qualitative information from patients, clinicians and KOOS/HOOS translators and analysis of data from 1,395 knee osteoarthritis (OA) and 1,281 hip OA patients from the FORCE-TJR cohort who completed KOOS or HOOS before and after total joint replacement (TJR). Item response theory models and computerized adaptive test (CAT) simulations were used to identify items that best measured patients' levels of pain and function pre- and post-TJR. KOOS-12/HOOS-12 items were selected based on content, coverage of a wide measurement range, high item information, item usage in CAT simulations, scale-level properties (reliability, validity, responsiveness), and qualitative information.

RESULTS

KOOS-12 and HOOS-12 each included a pain frequency item and three items measuring pain during increasingly difficult activities (sitting/lying, walking, up/down stairs); function items about standing, rising from sitting, getting in/out of a car, and twisting/pivoting (KOOS-12) or walking on an uneven surface (HOOS-12); and the original 4-item QOL scale.

CONCLUSIONS

This study demonstrated the benefits of examining patient-reported outcome measures using modern psychometric methods, to create short forms with diverse content that provide domain-specific and summary joint impact scores.

Reliability and validity of a Turkish version of the Sexual Quality of Life - Male questionnaire: a methodological study

Background The aim of this methodological study was to assess the reliability and validity of the Sexual Quality of Life - Male (SQoL-M) questionnaire translated and adapted to measure the sexual quality of life of men in Turkey and Northern Cyprus.

METHODS

To assess the reliability and validity of the Turkish version of the SQoL-M questionnaire, in January and February 2017 we formed a sample of 128 men from Ankara, Turkey, and Girne, Northern Cyprus, to complete the questionnaire. Two weeks later, 65 of these men completed the questionnaire during a retest. Factor analysis was conducted to evaluate the questionnaire's factor structure, internal consistency and test-retest reliability analyses were used to assess reliability and Pearson's correlation coefficient was used to measure criterion-related validity.

RESULTS

Cronbach's α for the Turkish version of the SQoL-M questionnaire was 0.91, with corrected item-total score correlations ranging from 0.432 to 0.819. The test-retest correlation, calculated to compare scale scores of both groups of participants, was 0.83 (P<0.001). We also observed a statistically significant relationship between the Turkish version of the SQoL-M questionnaire and the Arizona Sexual Experience scale.

CONCLUSIONS

The Turkish version of the SQoL-M questionnaire is a valid, reliable instrument for evaluating the sexual quality of life of men in Turkey and Northern Cyprus.

Cross-cultural adaptation and validation of the Italian version of the Hip disability and Osteoarthritis Outcome Score (HOOS)

Objective

To create a translated version of the HOOS to fit the Italian population and to test its psychometric properties and validity in hip osteoarthritis (OA) patients undergoing total hip arthroplasty (THA).

Design

The HOOS Italian version was developed according to published international guidelines that include preparation, forward translation and reconciliation, backward translation, review and harmonization, and proof reading. The Italian HOOS was administered to 145 patients (mean age 65.7 ± 11.6 years, 34–89, 58.6% women) undergoing THA. The following psychometric properties were evaluated: internal consistency (Cronbach’s alpha); test-retest reliability (Pearson’s r and intra-class correlation coefficient, ICC); convergent validity (Spearman’s rho between HOOS and SF-36); responsiveness (comparison of pre/post-THA scores, Wilcoxon signed rank test). Interpretability (floor and ceiling effects, skewness and kurtosis indexes) and acceptability (time to compiling, missing answers, and autonomy in compilation) were also evaluated.

Results

Translation and transcultural adaptation were conducted in accordance with the international recommendation. The translation was deemed understandable and appropriate as to the transcultural adaptation. None of the patients reported to have met any difficulties in reading and understanding the HOOS items. Internal consistency and test-retest reliability were good for each HOOS subscale (Cronbach’s alpha ≥0.7, Pearson’s r and ICC > 0.80). Convergent validity showed the highest correlations (Spearman’s rho > 0.5) between HOOS and SF-36 subscales relating to similar dimensions. As to responsiveness, all HOOS subscales scores improved significantly after THA (p < 0.01). Interpretability was acceptable despite ceiling effect in post-THA assessment. Acceptability was good: HOOS resulted easy and quick to fill out (12 min on average).

Conclusions

The HOOS was successfully cross-culturally adapted into Italian. The Italian HOOS showed good psychometric properties therefore it can be useful to assess outcomes in OA patients after THA. This study provided a basis for its use within the Italian Arthroplasty Registry and for future clinical trials.

Electronic supplementary material

The online version of this article (10.1186/s12955-018-0935-6) contains supplementary material, which is available to authorized users.

Translation and Cross-cultural Adaptation of the Hip Disability and Osteoarthritis Score into Persian Language: Reassessment of Validity and Reliability

Background:

This study aimed Persian translation and validation of the hip disability and osteoarthritis outcome score (HOOS) questionnaire.

Methods:

The study was carried out in two phases. First, we translated the HOOS according to acceptable guidelines. We assessed HOOS content convergent validity on 203 hip osteoarthritis patients using SF-36. Internal consistency was tested using Cronbach's alpha coefficient if each item removed and intraclass correlation coefficient (ICC) for the assessment of test-retest reproducibility.

Results:

Patients had mean (standard deviation) age of 39 (17). Test-retest ICC in whole was 0.95 (P = 0.014) showing excellent reliability. ICC was 0.92 for the “pain” subscale (P = 0.02), 0.81 for the “symptom” subscale (P = 0.002), 0.81 for the “function of daily living (FDL)” (P = 0.022), 0.88 for the “function of sports and recreational activities” (P = 0.006), but it was 0.62 (P = 0.1) for the “quality of life (QOL).” Cronbach's alpha was 0.92, 0.73, 0.97, 0.86, 0.80, and 0.80 for the pain, symptom, FDL, function of sports, QOL, and stiffness, respectively, showing good to excellent internal consistancy. Having SF-36 for the assessment of convergent validity, there was a strong correlation between total HOOS score and the physical component summary domain of SF-36 (r = 0.64, P = 0.0001), whereas the t correlation with the mental component summary domain was weak (r = 0.16, P = 0.04).

Conclusions:

The Persian version of the HOOS questionnaire is a valid (regarding physical not mental aspects) and reliable assessment tool in patients with hip osteoarthritis.

Assessment of reliability, validity, responsiveness and minimally important change of the German Hip dysfunction and osteoarthritis outcome score (HOOS) in patients with osteoarthritis of the hip

Patient-reported outcome measures are a critical tool in evaluating the efficacy of orthopedic procedures. The intention of this study was to evaluate reliability, validity, responsiveness and minimally important change of the German version of the Hip dysfunction and osteoarthritis outcome score (HOOS). The German HOOS was investigated in 251 consecutive patients before and 6 months after total hip arthroplasty. All patients completed HOOS, Oxford-Hip Score, Short-Form (SF-36) and numeric scales for pain and disability. Test-retest reliability, internal consistency, floor and ceiling effects, construct validity and minimal important change were analyzed. The German HOOS demonstrated excellent test-retest reliability with intraclass correlation coefficient values > 0.7. Cronbach´s alpha values demonstrated strong internal consistency. As hypothesized, HOOS subscales strongly correlated with corresponding OHS and SF-36 domains. All subscales showed excellent (effect size/standardized response means > 0.8) responsiveness between preoperative assessment and postoperative follow-up. The HOOS and all subdomains showed higher changes than the minimal detectable change which indicates true changes. The German version of the HOOS demonstrated good psychometric properties. It proved to be valid, reliable and responsive to the changes instrument for use in patients with hip osteoarthritis undergoing total hip replacement.

Transcultural adaptation of the Korean version of the Hip Outcome Score

PURPOSE

The Hip Outcome Score (HOS) is a questionnaire commonly used to assess the clinical outcome of patients after hip arthroscopy. However, a Korean version of the HOS is not available. The aim of this study was to translate and adapt the HOS questionnaire into the Korean language and then assess the psychometric properties of this instrument.

METHODS

Translation and transcultural adaptation of the HOS into Korean (HOS-K) was performed in accordance with the international recommendations. Sixty patients (mean age 38.4 years) planning hip arthroscopy participated in evaluating the psychometric properties of the HOS-K. Psychometric analyses consisted of assessing for the following: (1) floor/ceiling effects, (2) internal consistency using Cronbach's alpha, (3) test-retest reliability over 2-3 weeks with intraclass correlation coefficient (ICC), (4) convergent validity by correlation with the SF-36 and Hip disability and Osteoarthritis Outcome Score (HOOS), (5) construct validity by assessing for a difference in HOS-K scores based on a rating of hip function, and (6) responsiveness with a change in score over a 6-month period.

RESULTS

The English version of the HOS was translated and adapted to Korean without notable discrepancies. The HOS-K scores were reliable with ICC of 0.946 for the activities of daily living (ADL) subscale and 0.929 for the sports subscale. Internal consistency was confirmed by Cronbach's alpha >0.90 for both subscales. Both subscales had a strong correlation to the five subscales of SF-36, except the general health subscale. The ADL subscale showed strong correlations with all the subscales of the HOOS, and sports subscale showed strong correlations with all subscales of the HOOS, except the symptom subscales of HOOS. The HOS-K also demonstrated evidence for responsiveness without floor and ceiling effects.

CONCLUSION

The HOS-K can be recommended as an outcome instrument in hip arthroscopy for Korean-speaking individuals. Surgeons can use the HOS-K to evaluate the outcome of hip arthroscopy in Korea.

LEVEL OF EVIDENCE

Therapeutic case series with no comparison group, Level IV.

Transcultural adaptation and validation of the Korean version of Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILD)

PURPOSE

The aim of this study was to translate and transculturally adapt the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILD) questionnaire into Korean language, and to test the reliability and validity, including the internal consistency, known-group validity and factor analysis of the Korean version of the CPCHILD.

METHODS

A Korean version of CPCHILD was produced according to internationally accepted guidelines. For validity testing, 194 consecutive parents or caregivers of children with cerebral palsy (CP) were recruited and completed the questionnaire. Internal consistency, test-retest reliability, and known-groups validity were evaluated and factor analysis was performed to validate the Korean version of the CPCHILD.

RESULTS

In terms of internal consistency, a Cronbach's alpha was above 0.90 in all domains of the CPCHILD (range 0.921 to 0.966), except the 5th domain (0.628). In terms of known-groups validity, the total score of the CPCHILD was significantly different according to the Gross Motor Function Classification System (GMFCS) level (p < 0.001). Intra-class correlation coefficient spanned from 0.517 to 0.801. Factor analysis showed that the five-factor solution of the CPCHILD explained 76.7% of the variance with 59.0, 6.5, 5.1, 4.2 and 3.2% of variance by each components number.

CONCLUSIONS

The Korean version of CPCHILD was found to be a reliable and valid questionnaire of caregivers' perspectives on the health-related quality of life in severely affected children with CP. However, the Korean version of CPCHILD contains some redundant items, and factor analysis suggested a five-domain questionnaire. Implication for Rehabilitation The Korean version of CPCHILD is a reliable, internally consistent, valid instrument for assessing the health-related quality of life in severely affected children with CP from the perspective of caregivers. After the transcultural adaptation and validation of the Korean CPCHILD, it can be reliably used in clinical and research settings to evaluate the health-related quality of life in Korean patients with CP.

Osteoarthritis 2012 year in review: rehabilitation and outcomes

Recent scientific advances in the treatment of hip and knee osteoarthritis (OA) relating to education, exercise, weight control and passive non-pharmacological and non-surgical treatments such as manual therapy, orthoses/orthotics and other aids are described.

METHODS

A systematic literature search was performed in Medline from July 2011 to 10 April 2012 using the terms 'osteoarthritis, knee', 'osteoarthritis, hip' rehabilitation, physical therapy, exercise therapy and preoperative intervention; both as text words and as MeSH terms where possible. Trials evaluating rehabilitation interventions were included if they were randomized controlled trials (RCTs) or systematic reviews. Outcome papers were identified by combining the initial search with the terms 'outcome', 'measure*', 'valid*', 'reliabil*' or 'responsiveness'. Outcome studies were included if they contributed methodologically to advancing outcome measurement.

RESULTS

The literature search identified 550 potentially relevant papers. Seventeen RCTs on rehabilitation were selected and the results from these were supported by six systematic reviews. Sixteen outcomes papers were considered relevant, but did not add significantly to current knowledge about outcome measures in OA and so, were not included.

CONCLUSION

The current research focus on non-pharmacological and non-surgical treatments for hip and/or knee OA, when combined in systematic reviews, is improving the available evidence to identify best practice treatment. Education, exercise and weight loss are effective in the long term and supported as cost-effective first-line treatments.

Transcultural adaptation and testing of psychometric properties of the Korean version of the Oxford hip score

BACKGROUND

The Oxford hip score (OHS) is one of the most widely used scoring systems to assess clinical outcome for patients with total hip arthroplasty (THA). Few studies have evaluated the OHS in non-Western patients with other cultural backgrounds, particularly Asians. Translation and transcultural adaptation of the OHS into the Korean was performed in accordance with international recommendations and the psychometric properties were tested.

METHODS

For testing the psychometric properties, 150 patients (mean age, 51 years) planning THA were recruited, and floor/ceiling effects and internal consistency were determined. Test-retest reliability and convergent validity were assessed by correlation with the SF-36, HOOS, and VAS for pain for 122, and responsiveness was evaluated for 100.

RESULTS

The Korean version had satisfactory internal consistency, test-retest reliability, convergent validity, and responsiveness without floor and ceiling effects.

CONCLUSION

This study shows that the OHS developed in the West, with transcultural adaptation, is relevant for the patients undergoing THA in Korea.

Predictors of functional outcome following femoral neck fractures treated with an arthroplasty: limitations of the Harris hip score

INTRODUCTION

To study the association between potential prognostic factors and functional outcome at 1 and 5 year follow-up in patients with femoral neck fractures treated with an arthroplasty. To analyze the reliability of the Harris hip score (HHS).

MATERIALS AND METHODS

A multicenter analysis which included 252 patients who sustained a femoral neck fracture treated with an arthroplasty. Functional outcome after surgery was assessed using a modified HHS and was evaluated after 1 (HHS1) and 5 (HHS5) years. Several prognostic factors were analyzed and reliability of the HHS was assessed.

RESULTS

After 1 year the presence of co-morbidities was a significant (p = 0.002) predictor for a poor functional outcome (mean HHS1 71.8 with co-morbidities, and 80.6 without co-morbidities). After 5 years none of the potential prognostic factors had significant influence on functional outcome. Internal consistency testing of the HHS showed that when pain and function of the HHS were analyzed together, the internal consistency was poor (HHS1 0.38 and HHS5 0.20). The internal consistency of the HHS solely in function (without pain) improved to 0.68 (HHS1) and 0.46 (HHS5). Analyzing the functional aspect exclusively, age and the existence of co-morbidities could be defined as predictors for functional outcome of femoral neck fractures after 1 and 5 years.

CONCLUSION

After using the HHS in a modification, age and the existence of pre-operative co-morbidities appeared to be predictors of the functional outcome after 1 and 5 years. The HHS, omitting pain, is a more reliable score to estimate the functional outcome, than HHS analyzing pain and function in one scoring system.