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Gnanaratnam J, Perera R, Wickremasinghe R. Cultural adaptation and validation of the knee injury and osteoarthritis outcome score into Sinhala language in patients with primary knee osteoarthritis: a cross-sectional study. BMC Musculoskelet Disord 2024; 25:623. [PMID: 39103809 DOI: 10.1186/s12891-024-07752-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 08/01/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Knee Injury and Osteoarthritis Outcome Score (KOOS) scale is a patient-reported outcome measurement tool. It evaluates both short- and long-term consequences of knee injury and primary osteoarthritis. This study aims to translate and validate the KOOS scale for a Sinhala-speaking Sri Lankan population. METHODS A cross sectional study was conducted in three hospitals. Four hundred and fifteen patients comprising 185 males and 227 females (3 subjects did not reveal their gender) with knee osteoarthritis (KOA) participated in the study. Seventy nine participants without KOA were recruited as controls. The functionality and quality of life level in patients and healthy participants were assessed using translated versions of the KOOS and Short Form-36 (SF-36) scales. Internal consistency of the instrument was assessed by Cronbach alpha. Construct validity and test-retest reliability were examined using the Intraclass Correlation Coefficient (ICC). Confirmatory Factor Analysis (CFA) was used to assess factorial validity. RESULTS The mean age (± sd) of the KOA subjects was 54.9 (± 9.2) years and for the control group was 49.2 (± 8.0) years. Majority of the respondents were female and Sinhalese in both groups. Internal consistency reliability was high (Cronbach's alpha values ≥ 0.70). The test-retest reliability was excellent with the intraclass correlation coefficient for all subscales being above 0.90. Construct validity was assessed by the magnitude of the correlation coefficient between KOOS and SF-36 subscale scores. KOOS Pain scale moderately correlated with SF-36 bodily pain (Pearson's r = 0.41). SF-36 physical function scores had a weak positive correlation with all KOOS subscales and SF-36 emotional wellbeing was not significantly correlated with KOOS Quality of Life (QoL) subscale. A five-factor Confirmatory Factor Analysis (CFA) model yielded a Comparative Fit Index (CFI) = 0.950, Tucker Lewis Index (TLI) = 0.946, Root Mean Square Error of Approximation (RMSEA) = 0.082 and Standardised Root Mean squared Residual (SRMR) = 0.072. CONCLUSION The Sinhala translation of the KOOS scale is a reliable and valid instrument to assess KOA in a Sinhala-speaking Sri Lankan population. Studies to assess its use as a scale to evaluate responsiveness are recommended.
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Affiliation(s)
- Jigashalja Gnanaratnam
- Department of Public Health, Faculty of Medicine, University of Kelaniya, Thalagolla Road, P.O. Box 6, Ragama, 11010, Sri Lanka
| | - Ruwanthi Perera
- Department of Rogavijnana, Faculty of Indigenous Medicine, Gampaha Wickramarachchi University of Indigenous Medicine, Yakkala, Sri Lanka
| | - Rajitha Wickremasinghe
- Department of Public Health, Faculty of Medicine, University of Kelaniya, Thalagolla Road, P.O. Box 6, Ragama, 11010, Sri Lanka.
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Kekki C, Wörner T, Stålman A, von Essen C. Item-reduced Forgotten Joint Score provides adequate psychometric properties in ACLR patients. J Exp Orthop 2024; 11:e12058. [PMID: 38863939 PMCID: PMC11165472 DOI: 10.1002/jeo2.12058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 05/25/2024] [Accepted: 05/29/2024] [Indexed: 06/13/2024] Open
Abstract
Purpose The purpose of this study was to evaluate content validity, test-retest reliability, internal consistency, construct validity, responsiveness and floor/ceiling effects of Forgotten Joint Score (FJS) for assessing functions in activities of daily living (ADL) following anterior cruciate ligament reconstruction (ACLR) and perform an item reduction of FJS. Methods Swedish-speaking ACLR patients in one surgical clinic were eligible. Content validity was evaluated through patient responses and patient and expert clinician relevance ratings, omitting items with low relevance. Principal component factor analysis, Cronbach's ⍺, paired t test, correlations between FJS and Knee Injury and Osteoarthritis Outcome Score (KOOS), Cohen's d effect sizes (ESs) and standardized response mean (SRM) were used to evaluate internal consistency, test-retest reliability, construct validity and responsiveness. Floor/ceiling effects were calculated. FJS was expected to reveal one dominant factor, a Cronbach's ⍺ between 0.70 and 0.95, correlations >0.50 to all KOOS subscores, highest for ADL, moderate ES and SRM, floor/ceiling effects <15%. Results One hundred and seventy-six participants (103 for assessing internal consistency, construct validity, responsiveness and floor/ceiling effects; 73 for assessing test-retest reliability and content validity) were included. Item reduction yielded a nine-item FJS (FJS-9). FJS-12 and FJS-9 demonstrated sufficient content validity (95% confidence interval [CI], 2.5-3.1, respectively, 2.9-3.3). FJS-9 was found unidimensional, and FJS-12 was multidimensional. Cronbach's ⍺ was 0.94 for FJS, and the intraclass correlation coefficient > 0.90. FJS showed significant correlations >0.65 to all KOOS subscales, moderate ES and SRM > 0.50. No floor/ceiling effects were found. Conclusion FJS-9 demonstrated adequate validity for the evaluation of joint awareness in ACLR patients and can be a valuable tool to assess ADL and joint awareness. Level of Eidence Level III.
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Affiliation(s)
- Carolina Kekki
- Department of Molecular Medicine and SurgeryKarolinska InstituteStockholmSweden
| | - Tobias Wörner
- Department of Molecular Medicine and SurgeryKarolinska InstituteStockholmSweden
- Capio Artro Clinic, FIFA Medical Centre of Excellence, Sophiahemmet HospitalStockholmSweden
| | - Anders Stålman
- Department of Molecular Medicine and SurgeryKarolinska InstituteStockholmSweden
- Capio Artro Clinic, FIFA Medical Centre of Excellence, Sophiahemmet HospitalStockholmSweden
| | - Christoffer von Essen
- Department of Molecular Medicine and SurgeryKarolinska InstituteStockholmSweden
- Capio Artro Clinic, FIFA Medical Centre of Excellence, Sophiahemmet HospitalStockholmSweden
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Äärimaa V, Kohtala K, Rantalaiho I, Ekman E, Mäkelä K, Taskinen HS, Ryösä A, Kostensalo J, Meronen S, Laaksonen I. A Comprehensive Approach to PROMs in Elective Orthopedic Surgery: Comparing Effect Sizes across Patient Subgroups. J Clin Med 2024; 13:3073. [PMID: 38892784 PMCID: PMC11173138 DOI: 10.3390/jcm13113073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/10/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
Background: There is limited knowledge regarding the comparative patient-reported outcomes (PROMs) and effect sizes (ESs) across orthopedic elective surgery. Methods: All patient data between January 2020 and December 2022 were collected, and treatment outcomes assessed as a PROM difference between baseline and one-year follow-up. The cohort was divided into subgroups (hand, elbow, shoulder, spine, hip, knee, and foot/ankle). The PROM ESs were calculated for each patient separately, and patients with ES > 0.5 were considered responders. Results: In total, 7695 patients were operated on. The mean ES across all patient groups was 1.81 (SD 1.41), and the largest ES was observed in shoulder patients and the smallest in hand patients. Overall, shoulder, hip, and knee patients had a larger ES compared to hand, spine, and foot/ankle patients (p < 0.0001). The proportion of positive responders ranged between 91-94% in the knee, shoulder, and hip, and 69-70% in the hand, spine, and foot/ankle subgroups. Conclusions: The ESs are generally high throughout elective orthopedic surgery. However, based on our institutional observations, shoulder, hip, and knee patients experience larger treatment effects compared to hand, spine, and foot/ankle patients, among whom there are also more non-responders. The expected treatment outcomes should be clearly communicated to patients when considering elective surgery. Because of the study limitations, the results should be approached with some caution.
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Affiliation(s)
- Ville Äärimaa
- Department of Orthopedics and Traumatology, Turku University Hospital, Luolavuorenkatu 2, 20720 Turku, Finland; (V.Ä.); (I.R.); (E.E.); (K.M.); (H.-S.T.); (A.R.); (S.M.); (I.L.)
- The Faculty of Medicine, University of Turku, Kiinamyllynkatu 4-8, 20521 Turku, Finland
| | - Karita Kohtala
- The Faculty of Medicine, University of Turku, Kiinamyllynkatu 4-8, 20521 Turku, Finland
| | - Ida Rantalaiho
- Department of Orthopedics and Traumatology, Turku University Hospital, Luolavuorenkatu 2, 20720 Turku, Finland; (V.Ä.); (I.R.); (E.E.); (K.M.); (H.-S.T.); (A.R.); (S.M.); (I.L.)
| | - Elina Ekman
- Department of Orthopedics and Traumatology, Turku University Hospital, Luolavuorenkatu 2, 20720 Turku, Finland; (V.Ä.); (I.R.); (E.E.); (K.M.); (H.-S.T.); (A.R.); (S.M.); (I.L.)
| | - Keijo Mäkelä
- Department of Orthopedics and Traumatology, Turku University Hospital, Luolavuorenkatu 2, 20720 Turku, Finland; (V.Ä.); (I.R.); (E.E.); (K.M.); (H.-S.T.); (A.R.); (S.M.); (I.L.)
- The Faculty of Medicine, University of Turku, Kiinamyllynkatu 4-8, 20521 Turku, Finland
| | - Hanna-Stiina Taskinen
- Department of Orthopedics and Traumatology, Turku University Hospital, Luolavuorenkatu 2, 20720 Turku, Finland; (V.Ä.); (I.R.); (E.E.); (K.M.); (H.-S.T.); (A.R.); (S.M.); (I.L.)
| | - Anssi Ryösä
- Department of Orthopedics and Traumatology, Turku University Hospital, Luolavuorenkatu 2, 20720 Turku, Finland; (V.Ä.); (I.R.); (E.E.); (K.M.); (H.-S.T.); (A.R.); (S.M.); (I.L.)
- The Faculty of Medicine, University of Turku, Kiinamyllynkatu 4-8, 20521 Turku, Finland
| | - Joel Kostensalo
- Natural Resources Institute Finland, Yliopistokatu 6B, 80100 Joensuu, Finland;
| | - Saara Meronen
- Department of Orthopedics and Traumatology, Turku University Hospital, Luolavuorenkatu 2, 20720 Turku, Finland; (V.Ä.); (I.R.); (E.E.); (K.M.); (H.-S.T.); (A.R.); (S.M.); (I.L.)
| | - Inari Laaksonen
- Department of Orthopedics and Traumatology, Turku University Hospital, Luolavuorenkatu 2, 20720 Turku, Finland; (V.Ä.); (I.R.); (E.E.); (K.M.); (H.-S.T.); (A.R.); (S.M.); (I.L.)
- The Faculty of Medicine, University of Turku, Kiinamyllynkatu 4-8, 20521 Turku, Finland
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Ahmad MA, Moganan M, A Hamid MS, Sulaiman N, Moorthy U, Hasnan N, Yusof A. Comparison between Low-Level and High-Intensity Laser Therapy as an Adjunctive Treatment for Knee Osteoarthritis: A Randomized, Double-Blind Clinical Trial. Life (Basel) 2023; 13:1519. [PMID: 37511894 PMCID: PMC10381799 DOI: 10.3390/life13071519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Low-level (LLLT) and high-intensity laser therapy (HILT) can be beneficial additions to knee osteoarthritis (KOA) rehabilitation exercises; however, it is still being determined which electrophysical agent is more effective. AIM To compare the effects of LLLT and HILT as adjuncts to rehabilitation exercises (LL + EX and HL + EX) on clinical outcomes in KOA. METHODS Thirty-four adults with mild-to-moderate KOA were randomly allocated to either LL + EX or HL + EX (n = 17 each). Both groups underwent their respective intervention weekly for twelve weeks: LL + EX (400 mW, 830 nm, 10 to 12 J/cm2, and 400 J per session) or HL + EX (5 W, 1064 nm, 19 to 150 J/cm2, and 3190 J per session). The laser probe was placed vertically in contact with the knee and moved in a slow-scan manner on the antero-medial/lateral sides of the knee joint. Participants' Knee Injury and Osteoarthritis Outcome Score (KOOS), Numerical Pain Rating Scale (NPRS), active knee flexion, and Timed Up-and-Go test (TUG) were assessed. RESULTS Post intervention, both groups showed improvements in their KOOS, NPRS, active knee flexion, and TUG scores compared to baseline (p < 0.01). The mean difference of change in KOOS, NPRS, and active knee flexion scores for the HL + EX group surpassed the minimal clinically important difference threshold. In contrast, the LL + EX group only demonstrated clinical significance for the NPRS scores. CONCLUSIONS Incorporating HILT as an adjunct to usual KOA rehabilitation led to significantly higher improvements in pain, physical function, and knee-related disability compared to LLLT applied in scanning mode.
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Affiliation(s)
- Mohd Azzuan Ahmad
- Physiotherapy Programme, Centre for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
- Faculty of Sports and Exercise Science, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Mageswari Moganan
- Faculty of Sports and Exercise Science, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Mohamad Shariff A Hamid
- Sports Medicine Unit, Faculty of Medicine, Universiti Malaya Medical Centre, Kuala Lumpur 59100, Malaysia
| | - Norhuda Sulaiman
- Sports Medicine Unit, Faculty of Medicine, Universiti Malaya Medical Centre, Kuala Lumpur 59100, Malaysia
| | - Ushantini Moorthy
- Sports Medicine Unit, Faculty of Medicine, Universiti Malaya Medical Centre, Kuala Lumpur 59100, Malaysia
| | - Nazirah Hasnan
- Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 59100, Malaysia
| | - Ashril Yusof
- Faculty of Sports and Exercise Science, Universiti Malaya, Kuala Lumpur 50603, Malaysia
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Zhang Y, Ren J, Zang Y, Guo W, Disantis A, Martin RL. Cross-Culturally Adapted Versions of Patient Reported Outcome Measures for the Lower Extremity. Int J Sports Phys Ther 2023; V18:653-686. [PMID: 37425110 PMCID: PMC10324371 DOI: 10.26603/001c.74528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 03/08/2023] [Indexed: 07/11/2023] Open
Abstract
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.
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Affiliation(s)
- Yongni Zhang
- Rangos School of Health Sciences Duquesne- China Health Institute
| | - Jiayi Ren
- Shuguang Hospital of Shanghai University of Traditional Chinese Medicine
| | - Yaning Zang
- Department of Kinesiology Shanghai University of Sport
| | - Wenhao Guo
- Rangos School of Health Sciences Duquesne- China Health Institute
| | - Ashley Disantis
- Department of Physical Therapy Duquesne University
- UPMC Children's Hospital of Pittsburgh
| | - Robroy L Martin
- Department of Physical Therapy Duquesne University
- UPMC Center for Sports Medicine
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Siren J, Rämö L, Rantasalo M, Komulainen O, Skants N, Reito A, Kosola J, Lindahl J. Unicompartmental knee arthroplasty vs. high tibial osteotomy for medial knee osteoarthritis (UNIKORN): a study protocol of a randomized controlled trial. Trials 2023; 24:256. [PMID: 37016454 PMCID: PMC10074655 DOI: 10.1186/s13063-023-07263-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 03/18/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Medial knee osteoarthritis (OA) is a common health problem resulting in knee pain and limiting patients' physical activity. After failed conservative treatment, unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO) are possible surgical treatment options for this condition. There is a paucity of high-quality evidence in the literature comparing objective and subjective outcomes of these procedures. Also, there is no common agreement on whether these procedures provide comparable results in late-stage medial knee OA patients. METHODS We will perform a prospective randomized controlled trial comparing HTO and UKA in patients with late-stage medial knee OA. 100 patients with isolated medial knee OA (KL III-IV) are assigned to either UKA (n = 50) or HTO (n = 50) procedure in patients 45-65 years of age. Our primary outcome will be KOOS5 at one year postoperatively. Secondary outcomes include OARSI physical assessment, length of stay, wearable activity watch, radiographs (OA progression according to Kellgren-Lawrence classification), patient-reported outcomes (KOOS subscales, pain visual analog scale [VAS], Lysholm, and Oxford knee scores), and adverse events (conversion to total knee arthroplasty, surgery-related complications, need for revision surgery) outcomes. Our hypothesis is that neither of the interventions is superior as measured with KOOS5 at 12 months. ETHICS AND DISSEMINATION The institutional review board of the Helsinki and Uusimaa Hospital District has approved the protocol. We will disseminate the findings through peer-reviewed publications. TRIAL REGISTRATION ClinicalTrials.gov/TooloH NCT05442242. Registered on 7/1/2022.
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Affiliation(s)
- Juuso Siren
- Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Topeliuksenkatu 5, 00260, Helsinki, Finland.
| | - Lasse Rämö
- Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Topeliuksenkatu 5, 00260, Helsinki, Finland
| | - Mikko Rantasalo
- Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Topeliuksenkatu 5, 00260, Helsinki, Finland
| | - Olli Komulainen
- Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Topeliuksenkatu 5, 00260, Helsinki, Finland
| | - Noora Skants
- Department of Anaesthesiology, Intensive Care and Pain Medicine, Peijas Hospital, HUS Helsinki University Hospital, Sairaalakatu 1, 01400, Vantaa, Finland
| | - Aleksi Reito
- Department of Orthopaedics and Traumatology, Tampere University Hospital, Elämänaukio 2, 33520, Tampere, Finland
| | - Jussi Kosola
- Department of Orthopaedics and Traumatology, Kanta-Häme Central Hospital, Ahvenistontie 20, 13530, Hämeenlinna, Finland
| | - Jan Lindahl
- Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Topeliuksenkatu 5, 00260, Helsinki, Finland
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Ahmad MA, Yusof A, Hamid MSA, Zulkifli Amin FH, Kamsan SS, Ag Daud DM, Ajit Singh DK. Effects of Self-management Program as Adjunctive to Usual Rehabilitation Exercise on Pain and Functional Outcomes in Knee Osteoarthritis: A Randomized Controlled Trial. J Res Health Sci 2023; 23:e00569. [PMID: 37571940 PMCID: PMC10422143 DOI: 10.34172/jrhs.2023.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/12/2022] [Accepted: 01/02/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Home-based exercise (HBE) and patient education (EDU) have been reported as beneficial additions to usual knee osteoarthritis (KOA) rehabilitation. However, previous trials mostly examined the effects of HBE and EDU separately. Thus, this study aimed to evaluate the effects of a structured combined HBE and EDU program in addition to usual KOA rehabilitation on pain score, functional mobility, and disability level. STUDY DESIGN A parallel-group, single-blinded randomized controlled trial. METHODS Eighty adults with KOA were randomly allocated to experimental (n=40) and control (n=40) groups. All participants underwent their usual physiotherapy care weekly for eight weeks. The experimental group received a structured HBE+EDU program to their usual care, while the control group performed home stretching exercises to equate treatment time. The Knee Injury and Osteoarthritis Outcome Score (KOOS) for the disability level, visual analogue scale (VAS) for pain, and timed up-and-go test (TUG) for mobility were measured pre-post intervention. RESULTS After eight weeks, the experimental group demonstrated significant improvements in the KOOS (all subscales), pain VAS, and TUG scores compared to baseline (P<0.001); meanwhile, only KOOS (activities of daily living and sports subscales) was significant in the control group. Relative to the control, the experimental group presented higher improvements (P<0.001) by 22.2%, 44.1%, and 15.7% for KOOS, pain VAS, and TUG, respectively. CONCLUSION Integrating the HBE+EDU program into usual KOA rehabilitation could reduce pain and disability, while it improved functional mobility. The finding of this study suggests a combination of a structured HBE and EDU program to be considered as part of mainstream KOA management.
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Affiliation(s)
- Mohd Azzuan Ahmad
- Physiotherapy Program, Centre for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Faculty of Sports and Exercise Science, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Ashril Yusof
- Faculty of Sports and Exercise Science, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mohamad Shariff A Hamid
- Sports Medicine Unit, Faculty of Medicine, Universiti Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Faizul Hafiz Zulkifli Amin
- Physiotherapy Program, Centre for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Siti Salwana Kamsan
- Department of Physical Rehabilitation Sciences, Faculty of Allied Health Sciences, International Islamic University Malaysia, Pahang, Malaysia
| | - D Maryama Ag Daud
- HEAL Research Unit, Faculty of Medicine and Health Science, Universiti Malaysia Sabah, Sabah, Malaysia
| | - Devinder Kaur Ajit Singh
- Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Repo JP, Uimonen MM, Nevalainen MT, Nurmi H, Ponkilainen VT, Tuominen A, Paloneva J. Outcomes following the operative treatment of intra-articular fracture combined with medial patellofemoral ligament reconstruction after patellar dislocation. Knee Surg Relat Res 2022; 34:21. [PMID: 35418118 PMCID: PMC9008916 DOI: 10.1186/s43019-022-00150-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 04/03/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose We examine the outcomes following operative treatment of intra-articular fracture combined with medial patellofemoral ligament (MPFL) reconstruction after patella dislocation. Methods Patients were retrospectively identified from medical records using diagnostic and surgical procedure codes. Radiological anatomical parameters and bony abnormalities of injured knees were assessed from magnetic resonance images (MRI). Inclusion criteria were traumatic patellar dislocation with chondral or osteochondral fracture and MPFL rupture, operative treatment of a chondral or osteochondral fracture combined with MPFL reconstruction, and minimum follow-up of 2 years. Outcomes were measured using the Kujala score, Tegner activity scale, and the Knee injury and Osteoarthritis Outcome Score Quality-of-Life subscale (KOOS-QLS). Results During 2012 and 2015, 322 patients were treated because of patellar dislocation. Thirty-three patients had chondral or osteochondral fracture. Eleven patients (five males and six females) with a mean [standard deviation (SD)] age of 17.0 (6.5) years at the time of surgery met the inclusion criteria and were included. Five of the 11 patients had a subchondral and six an osteochondral fracture. Eight patients had a fracture in the patella and three in the femur. All patients had bony abnormalities in the knee. Nine out of 11 patients scored over 90/100 points on the Kujala scale and had good results on the Tegner scale [before surgery 5.0 (2.7) points versus after surgery 5.3 (1.6) points] and the KOOS-QLS [4.1 (4.2) points] outcome measures. Conclusion The removal or fixation of the fracture fragment combined with MPFL reconstruction is a feasible option in the treatment of symptomatic osteochondral or subchondral fragment in traumatic patellar dislocation. The short-term outcomes are encouraging. Level of evidence: Level IV, retrospective case series.
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Hietamo J, Rantala A, Parkkari J, Leppänen M, Rossi M, Heinonen A, Steffen K, Kannus P, Mattila V, Pasanen K. Injury History and Perceived Knee Function as Risk Factors for Knee Injury in Youth Team-Sports Athletes. Sports Health 2022; 15:26-35. [PMID: 35037493 PMCID: PMC9808828 DOI: 10.1177/19417381211065443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The identification of risk factors for sports injuries is essential before injury prevention strategies can be planned. HYPOTHESIS Previous acute knee injury and lower perceived knee function measured by Knee injury and Osteoarthritis Outcome Score (KOOS) will increase the risk of acute knee injury in youth team-sports athletes. STUDY DESIGN Prospective cohort study. LEVEL OF EVIDENCE Level 3. METHODS At baseline, youth (≤21 years old) male and female basketball and floorball athletes completed a questionnaire on previous acute knee injuries and perceived knee function (KOOS). A total of 211 male and 183 female athletes were followed for an acute knee injury up to 3 years. Unadjusted and adjusted Cox regression models were used in risk factor analyses. RESULTS In male athletes, previous acute knee injury and lower KOOS Pain, Activities of Daily Living, Sport and Recreation, and knee-related Quality of Life subscale scores increased the risk of acute knee injury in the unadjusted analyses. Adjusted analyses for male injuries were not performed because of low number of acute knee injuries (n = 18). In female athletes, previous acute knee injury increased the risk of acute knee injury when adjusted for athletes' age and body mass index (hazard ratio, 2.6 [95% CI, 1.3-5.2]). In female athletes, none of the KOOS subscale scores were associated with the increased risk of acute knee injury in the adjusted analyses. CONCLUSION Previous acute knee injury was associated with the risk of new acute knee injury in youth male and female athletes. In youth male athletes, additionally, lower perceived knee function in 4 out of 5 KOOS subscale scores were associated with the increased risk of new acute knee injury. CLINICAL RELEVANCE The treatment and rehabilitation of the present acute knee injury and secondary prevention of reinjury should be emphasized in youth team-sports athletes.
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Affiliation(s)
- Jussi Hietamo
- Jussi Hietamo, MD, Tampere
Research Center of Sport Medicine, UKK Institute for Health Promotion Research,
Laavukatu 8 C 11, Tampere, 33580, Finland (
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Knee Injury and Osteoarthritis Outcome Score: Validity and Reliability of an Indonesian Version. Ochsner J 2021; 21:63-67. [PMID: 33828426 PMCID: PMC7993429 DOI: 10.31486/toj.20.0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: The Knee injury and Osteoarthritis Outcome Score (KOOS) is a useful diagnostic tool to assess knee ligament injury and osteoarthritis, but no validated Indonesian version of the KOOS was available. Methods: We used the forward-backward translation protocol to develop the Indonesian version of the KOOS. The translated questionnaire was administered twice to 51 subjects diagnosed with a knee ligament injury and osteoarthritis. Validity of the questionnaire was assessed by analyzing the correlation between the score of each subscale and the overall score of the 36-Item Short Form Health Survey (SF-36) using the Pearson correlation coefficient. Reliability was measured by evaluating internal consistency (Cronbach α) and test-retest reliability (intraclass correlation coefficient). Results: For construct validity, moderate Pearson correlation coefficients were found between the KOOS subscales and the SF-36. Cronbach α was 0.84 to 0.97 for all subscales, indicating adequate internal consistency. The test-retest reliability was excellent, with intraclass correlation coefficients ranging from 0.91 to 0.99 for all subscales. No significant differences were found in the KOOS subscale responses between the first administration of the questionnaire and the second administration within 21 days. Conclusion: The Indonesian version of the KOOS was determined to be valid and reliable and is therefore an objective instrument for evaluating knee ligament injury and knee osteoarthritis in the Indonesian population.
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Heikkinen R, Waller B, Munukka M, Multanen J, Heinonen A, Karvanen J. Impact or no impact for women with mild knee osteoarthritis? A Bayesian meta-analysis of two RCT's with contrasting interventions. Arthritis Care Res (Hoboken) 2021; 74:1133-1141. [PMID: 33421328 DOI: 10.1002/acr.24553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/23/2020] [Accepted: 01/05/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE We aim to predict the probability of a benefit from two contrasting exercise programs for a woman with a new diagnosis of mild knee osteoarthritis (OA). The short and long-term effects of aquatic resistance training (ART) and high-impact aerobic land training (HLT) compared with the control will be estimated. METHODS Original data sets from two previously conducted randomised controlled trials (RCT) were combined and used in a Bayesian meta-analysis. Group differences in multiple response variables were estimated. Variables included cardiorespiratory fitness, dynamic maximum leg muscle power, maximal isometric knee extension and flexion force, pain, other symptoms and quality of life. The statistical model included a latent commitment variable for each female participant. RESULTS ART has 55% - 71% probability of benefits in the outcome variables and as the main effect, the intervention outperforms the control in cardiorespiratory fitness with a probability of 71% immediately after the intervention period. HLT has 46% - 63% probability of benefits after intervention with the outcome variables, but differently from ART, the positive effects of physical performance fade away during the follow-up period. Overall, the differences between groups were small and the variation in the predictions between individuals was high. CONCLUSIONS Both interventions had benefits but ART has a slightly higher probability of long-term benefits on physical performance. Because of high individual variation and no clear advantage of one training method over the other, personal preferences should be considered in the selection of the exercise program to ensure highest commitment to training.
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Affiliation(s)
- Risto Heikkinen
- University of Jyväskylä, Department of Mathematics and Statistics, Jyvaskyla, Finland
| | - Benjamin Waller
- University of Jyväskylä, Sports Science Department, Jyvaskyla, Finland
| | - Matti Munukka
- University of Jyväskylä, Department of Health Sciences, Jyvaskyla, Finland
| | - Juhani Multanen
- University of Jyväskylä, Faculty of Sports and Health Sciences, Jyvaskyla, Finland
| | - Ari Heinonen
- University of Jyväskylä, Department of Health Sciences, Jyvaskyla, Finland
| | - Juha Karvanen
- University of Jyväskylä, Department of Mathematics and Statistics, Jyvaskyla, Finland
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Florescu S, Vermesan D, Haragus H, Patrascu JM, Timar B, Todor A. Cross-cultural adaptation and validation of the Romanian knee disability and osteoarthritis outcome score for joint replacement (KOOSJR). BMC Musculoskelet Disord 2020; 21:155. [PMID: 32145742 PMCID: PMC7060578 DOI: 10.1186/s12891-020-3183-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 03/02/2020] [Indexed: 12/02/2022] Open
Abstract
Aim To perform validation of the Romanian Knee disability and Osteoarthritis Outcome Score for Joint Replacement (KOOSJR). Method Ninety-six patients (101 knees) with advanced osteoarthritis (OA) scheduled for total knee replacement completed Romanian translations of KOOSJR and IKDC (International Knee Documentation Committee – subjective knee form) and Euroqol EQ-5D-5 L, and the treating physician completed the original knee society score (KSS). Results Average age was 66.4 (range 50–83) years and male to female ratio 1:3.76. There was moderate correlation between the test-retest (average 4 days) KOOSJR (r = 0.618, n = 45) and IKDC (r = − 0.671, n = 99), weak between KOOSJR and EQ-5D-5 L Index (r = − 0.431, n = 100) and VAS (r = − 0.364, n = 99) and very weak to KSS score (r = − 0.133, n = 98) and function (r = − 0.072, n = 97) For the first KOOSJR, Cronbach’s alpha was 0.816 and intraclass correlation coefficient (ICC) 0.816 (95% CI 0.755–0.866) for average measures. For the retest, Cronbach’s alpha was 0.841 (95% CI 0.760–0.903) for averages. Conclusion The Romanian Knee disability and Osteoarthritis Outcome Score for Joint Replacement (KOOSJR) is a valid, reliable, consistent and reproducible clinical score for patients with OA requiring arthroplasty.
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Affiliation(s)
- Sorin Florescu
- Department of Orthopedics and Trauma, 'Victor Babes' University of Medicine and Pharmacy, No 2 Eftimie Murgu Square, 300723, Timisoara, Romania
| | - Dinu Vermesan
- Department of Orthopedics and Trauma, 'Victor Babes' University of Medicine and Pharmacy, No 2 Eftimie Murgu Square, 300723, Timisoara, Romania
| | - Horia Haragus
- Department of Orthopedics and Trauma, 'Victor Babes' University of Medicine and Pharmacy, No 2 Eftimie Murgu Square, 300723, Timisoara, Romania.
| | - Jenel M Patrascu
- Department of Orthopedics and Trauma, 'Victor Babes' University of Medicine and Pharmacy, No 2 Eftimie Murgu Square, 300723, Timisoara, Romania
| | - Bogdan Timar
- Department of Functional Sciences, 'Victor Babes' University of Medicine and Pharmacy, No 2 Eftimie Murgu Square, Timisoara, Romania
| | - Adrian Todor
- Department of Orthopedics, Traumatology and Pediatric Orthopedics, "Iuliu Hatieganu" University of Medicine and Pharmacy, No 8 Victor Babes Str, Cluj-Napoca, Romania
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Cross-Cultural Adaptation and Validation of the Hong Kong Version of the Knee Injury and Osteoarthritis Outcome Score (HK-KOOS) for Patients with Knee Osteoarthritis. Occup Ther Int 2019; 2019:8270637. [PMID: 31485200 PMCID: PMC6710745 DOI: 10.1155/2019/8270637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 07/12/2019] [Accepted: 07/29/2019] [Indexed: 12/18/2022] Open
Abstract
Introduction This study aimed to validate the Hong Kong version of the Knee Injury and Osteoarthritis Outcome Score (HK-KOOS) for patients with knee osteoarthritis. Methods Content validity was assessed using the Item and Scale Content Validity Index (I-CVI and S-CVI). Test-retest reliability and internal consistency were assessed by the Intraclass Correlation Coefficient (ICC) and Cronbach's alpha. Dimensionality was assessed by performing exploratory factor analysis (EFA). Convergent and Divergent Validity was performed by examining the correlation between the HK-KOOS and the Chinese version of the Short Form 12 (SF-12) Health Survey, the Chinese Modified Barthel Index (C-MBI), and the Visual Analogue Scale for Pain (VAS-Pain). Ceiling and floor effects were also examined. Results A total of 125 participants were recruited in this study. In general, all instructions, items, and response options were considered as understandable, indicating a satisfactory cross-cultural adaptation. The I-CVI and S-CVI scores were 0.80-1 and 0.90-1, respectively, indicating excellent content validity in terms of relevance, representativeness, and understandability. The test-retest reliability of all HK-KOOS subscales was satisfactory with ICC exceeding 0.70 for all domains. Cronbach's alpha exceeded 0.80 for all subscales, indicating satisfactory internal consistency. Medium to strong correlations were found between the HK-KOOS and the VAS-Pain, SF-12, and C-MBI. However, factor analysis indicated a seven-factor structure, rather than the original five-factor structure. Items on pain and activities of daily living were loaded in the same factors. A floor effect was present in the sports and recreation subscale. Discussion and Conclusions Future studies should further examine the dimensionality of the KOOS. The HK-KOOS is a culturally adapted, reliable, and valid outcome measure instrument to be used in Hong Kong patients with primary knee osteoarthritis.
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