Journal of Research in Rehabilitation Sciences

The Responsiveness of Oxford Knee Score in Iranian Patients with Knee Osteoarthritis Following Physiotherapy Intervention

Document Type : Original Articles

Authors

1 Associate Professor, Department of Physiotherapy, School of Rehabilitation Sciences AND Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor, Department of Physical Therapy, School of Paramedical Sciences AND Orthopedic Research Center Mashhad University of Medical Sciences, Mashhad, Iran

3 Assistant Professor, Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran

4 MSc Student, Student Research Committee (Treata), Department of Physiotherapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

10.22122/jrrs.v14i1.2973

Abstract

Introduction: The main purpose of physiotherapy in patients with knee osteoarthritis includes reducing pain, improving individual functional abilities, and increasing quality of life. Thus, the therapists need a tool to measure the outcome of these changes after intervention. In order to utilize these tools, they should have acceptable validity, reliability, and responsiveness. The Oxford Knee Score (OKS) is one of the most common tools used for assessment of the patients with knee osteoarthritis. However, to our knowledge, there has been no study on its responsiveness in this group of the patients. Therefore, the purpose of this study was to investigate the responsiveness of this outcome measure, and to measure minimal clinically important change in the patients with knee osteoarthritis following physiotherapy.Materials and Methods: 146 Iranian men and women with knee osteoarthritis referred to physiotherapist were entered the study via a nonrandomized convenience sampling method. The Oxford Knee Score was completed in the first session, and again after four weeks of physiotherapy. In the last session, the patients filled a 7-item retrograde Likert questionnaire, tooResults: The area under the curve (AUC) of 0.78, and δ correlation coefficient of 0.59 indicated high responsiveness of Oxford Knee Score. The sensitivity and specificity of scale was 0.50 and 0.91, respectively. The minimal clinically important change (MCIC) of this tool was 6.5.Conclusion: Our findings provide evidence for selection of appropriate outcome measure for assessment of changes in these patients. The minimal clinically important change of this tool was determined which provide practical information for clinicians to make decision on clinical significance of changes in patients status.

Keywords

  1. Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum 2008; 58(1): 26-35.
  2. Hsiao CJ, Cherry DK, Beatty PC, Rechtsteiner EA. National Ambulatory Medical Care Survey: 2007 summary. Natl Health Stat Report 2010; (27): 1-32.
  3. Guccione AA, Felson DT, Anderson JJ, Anthony JM, Zhang Y, Wilson PW, et al. The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health 1994; 84(3): 351-8.
  4. Rogind H, Bibow-Nielsen B, Jensen B, Moller HC, Frimodt-Moller H, Bliddal H. The effects of a physical training program on patients with osteoarthritis of the knees. Arch Phys Med Rehabil 1998; 79(11): 1421-7.
  5. Haq SA, Davatchi F. Osteoarthritis of the knees in the COPCORD world. Int J Rheum Dis 2011; 14(2): 122-9.
  6. Hawker GA. Experiencing painful osteoarthritis: What have we learned from listening? Curr Opin Rheumatol 2009; 21(5): 507-12.
  7. McAlindon TE, Bannuru RR, Sullivan MC, Arden NK, Berenbaum F, Bierma-Zeinstra SM, et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage 2014; 22(3): 363-88.
  8. Larmer PJ, Reay ND, Aubert ER, Kersten P. Systematic review of guidelines for the physical management of osteoarthritis. Arch Phys Med Rehabil 2014; 95(2): 375-89.
  9. Zhang W, Nuki G, Moskowitz RW, Abramson S, Altman RD, Arden NK, et al. OARSI recommendations for the management of hip and knee osteoarthritis: part III: Changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthritis Cartilage 2010; 18(4): 476-99.
  10. Irrgang JJ, Anderson AF. Development and validation of health-related quality of life measures for the knee. Clin Orthop Relat Res 2002; (402): 95-109.
  11. Husted JA, Cook RJ, Farewell VT, Gladman DD. Methods for assessing responsiveness: a critical review and recommendations. J Clin Epidemiol 2000; 53(5): 459-68.
  12. Ma C, Wu S, Xiao L, Xue Y. Responsiveness of the Chinese version of the Oswestry disability index in patients with chronic low back pain. Eur Spine J 2011; 20(3): 475-81.
  13. French HP, Fitzpatrick M, FitzGerald O. Responsiveness of physical function outcomes following physiotherapy intervention for osteoarthritis of the knee: an outcome comparison study. Physiotherapy 2011; 97(4): 302-8.
  14. Stratford PW, Binkley JM, Riddle DL. Health status measures: strategies and analytic methods for assessing change scores. Phys Ther 1996; 76(10): 1109-23.
  15. Kamper SJ, Maher CG, Mackay G. Global rating of change scales: A review of strengths and weaknesses and considerations for design. J Man Manip Ther 2009; 17(3): 163-70.
  16. Dawson J, Fitzpatrick R, Murray D, Carr A. Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br 1998; 80(1): 63-9.
  17. Murray DW, Fitzpatrick R, Rogers K, Pandit H, Beard DJ, Carr AJ, et al. The use of the Oxford hip and knee scores. J Bone Joint Surg Br 2007; 89(8): 1010-4.
  18. Ebrahimzadeh MH, Makhmalbaf H, Birjandinejad A, Soltani-Moghaddas SH. Cross-cultural adaptation and validation of the persian version of the oxford knee score in patients with knee osteoarthritis. Iran J Med Sci 2014; 39(6): 529-35.
  19. Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 1986; 29(8): 1039-49.
  20. Dobson F, Hinman RS, Roos EM, Abbott JH, Stratford P, Davis AM, et al. OARSI recommended performance-based tests to assess physical function in people diagnosed with hip or knee osteoarthritis. Osteoarthritis Cartilage 2013; 21(8): 1042-52.
  21. Altman RD, Gold GE. Atlas of individual radiographic features in osteoarthritis, revised. Osteoarthritis Cartilage 2007; 15(Suppl A): A1-56.
  22. Hawker GA, Stewart L, French MR, Cibere J, Jordan JM, March L, et al. Understanding the pain experience in hip and knee osteoarthritis--an OARSI/OMERACT initiative. Osteoarthritis Cartilage 2008; 16(4): 415-22.
  23. Zeni JA, Jr., Higginson JS. Differences in gait parameters between healthy subjects and persons with moderate and severe knee osteoarthritis: a result of altered walking speed? Clin Biomech (Bristol, Avon) 2009; 24(4): 372-8.
  24. Schultz-Larsen K, Lomholt RK, Kreiner S. Mini-Mental Status Examination: a short form of MMSE was as accurate as the original MMSE in predicting dementia. J Clin Epidemiol 2007; 60(3): 260-7.
  25. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis 1957; 16(4): 494-502.
  26. de Vet HC, Foumani M, Scholten MA, Jacobs WC, Stiggelbout AM, Knol DL, et al. Minimally important change values of a measurement instrument depend more on baseline values than on the type of intervention. J Clin Epidemiol 2015; 68(5): 518-24.
  27. Houweling TAW. Reporting improvement from patient-reported outcome measures: A review. Clinical Chiropractic 2010; 13(1): 15-22.
  28. Deyo RA, Centor RM. Assessing the responsiveness of functional scales to clinical change: An analogy to diagnostic test performance. J Chronic Dis 1986; 39(11): 897-906.
  29. Lehman LA, Sindhu BS, Shechtman O, Romero S, Velozo CA. A comparison of the ability of two upper extremity assessments to measure change in function. J Hand Ther 2010; 23(1): 31-40.
  30. Lehman LA, Velozo CA. Ability to detect change in patient function: responsiveness designs and methods of calculation. J Hand Ther 2010; 23(4): 361-70.
  31. Florkowski CM. Sensitivity, specificity, receiver-operating characteristic (ROC) curves and likelihood ratios: communicating the performance of diagnostic tests. Clin Biochem Rev 2008; 29 Suppl 1: S83-S87.
  32. Collins NJ, Misra D, Felson DT, Crossley KM, Roos EM. Measures of knee function: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL), Lysholm Knee Scoring Scale, Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Activity Rating Scale (ARS), and Tegner Activity Score (TAS). Arthritis Care Res (Hoboken) 2011; 63(Suppl 11): S208-S228.
  33. Goldhahn S, Takeuchi R, Nakamura N, Nakamura R, Sawaguchi T. Responsiveness of the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Oxford Knee Score (OKS) in Japanese patients with high tibial osteotomy. J Orthop Sci 2017; 22(5): 862-7.
  34. Ko Y, Lo NN, Yeo SJ, Yang KY, Yeo W, Chong HC, et al. Comparison of the responsiveness of the SF-36, the Oxford Knee Score, and the Knee Society Clinical Rating System in patients undergoing total knee replacement. Qual Life Res 2013; 22(9): 2455-9.
  35. Harris KK, Dawson J, Jones LD, Beard DJ, Price AJ. Extending the use of PROMs in the NHS--using the Oxford Knee Score in patients undergoing non-operative management for knee osteoarthritis: a validation study. BMJ Open 2013; 3(8): e003365.
  36. Clement ND, MacDonald D, Simpson AH. The minimal clinically important difference in the Oxford knee score and Short Form 12 score after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2014; 22(8): 1933-9.
Journal of Research in Rehabilitation Sciences
Volume 14, Issue 1 - Serial Number 1
March 2018
Pages 1-8