The OARSI core set of performance-based measures for knee osteoarthritis is reliable but not valid and responsive

J.J. Tolk; R.P.A. Janssen; C.A.C. Prinsen; D.A.J.M. Latijnhouwers; M.C. van der Steen; S.M.A. Bierma-Zeinstra; M. Reijman

doi:10.1007/s00167-017-4789-y

The OARSI core set of performance-based measures for knee osteoarthritis is reliable but not valid and responsive

J.J. Tolk (Corresponding author), R.P.A. Janssen, C.A.C. Prinsen, D.A.J.M. Latijnhouwers, M.C. van der Steen, S.M.A. Bierma-Zeinstra, M. Reijman

Orthopaedic Biomechanics

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

PURPOSE: The Osteoarthritis Research Society International has identified a core set of performance-based tests of physical function for use in people with knee osteoarthritis (OA). The core set consists of the 30-second chair stand test (30-s CST), 4 × 10 m fast-paced walk test (40 m FPWT) and a stair climb test. The aim of this study was to evaluate the reliability, validity and responsiveness of these performance-based measures to assess the ability to measure physical function in knee OA patients.

METHODS: A prospective cohort study of 85 knee OA patients indicated for total knee arthroplasty (TKA) was performed. Construct validity and responsiveness were assessed by testing of predefined hypotheses. A subgroup (n = 30) underwent test-retest measurements for reliability analysis. The Oxford Knee Score, Knee injury and Osteoarthritis Outcome Score-Physical Function Short Form, pain during activity score and knee extensor strength were used as comparator instruments. Measurements were obtained at baseline and 12 months after TKA.

RESULTS: Appropriate test-retest reliability was found for all three tests. Intraclass correlation coefficient (ICC) for the 30-s CST was 0.90 (95% CI 0.68; 0.96), 40 m FPWT 0.93 (0.85; 0.96) and for the 10-step stair climb test (10-step SCT) 0.94 (0.89; 0.97). Adequate construct validity could not be confirmed for the three tests. For the 30-s CST, 42% of the predefined hypotheses were confirmed; for the 40 m FPWT, 27% and for the 10-step SCT 36% were confirmed. The 40 m FPWT was found to be responsive with 75% of predefined hypothesis confirmed, whereas the responsiveness for the other tests could not be confirmed. For the 30 s CST and 10-step SCT, only 50% of hypotheses were confirmed.

CONCLUSIONS: The three performance-based tests had good reliability, but poor construct validity and responsiveness in the assessment of function for the domains sit-to-stand movement, walking short distances and stair negotiation. The findings of the present study do not justify their use for clinical practice.

LEVEL OF EVIDENCE: Level 1. Diagnostic study.

Original language	English
Pages (from-to)	2898-2909
Number of pages	12
Journal	Knee Surgery, Sports Traumatology, Arthroscopy
Volume	27
Issue number	9
DOIs	https://doi.org/10.1007/s00167-017-4789-y
Publication status	Published - Sept 2019

Keywords

Functional outcome
Osteoarthritis
Performance-based measures
Total knee arthroplasty
Prospective Studies
Follow-Up Studies
Humans
Middle Aged
Osteoarthritis, Knee/diagnosis
Pain/surgery
Male
Exercise Test
Time Factors
Range of Motion, Articular
Female
Knee Joint/physiopathology
Surveys and Questionnaires
Arthroplasty, Replacement, Knee/standards
Severity of Illness Index
Reproducibility of Results
Walking
Aged
Pain Measurement
Walk Test
Preoperative Period

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Tolk, J. J., Janssen, R. P. A., Prinsen, C. A. C., Latijnhouwers, D. A. J. M., van der Steen, M. C., Bierma-Zeinstra, S. M. A., & Reijman, M. (2019). The OARSI core set of performance-based measures for knee osteoarthritis is reliable but not valid and responsive. Knee Surgery, Sports Traumatology, Arthroscopy, 27(9), 2898-2909. https://doi.org/10.1007/s00167-017-4789-y

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title = "The OARSI core set of performance-based measures for knee osteoarthritis is reliable but not valid and responsive",

abstract = "PURPOSE: The Osteoarthritis Research Society International has identified a core set of performance-based tests of physical function for use in people with knee osteoarthritis (OA). The core set consists of the 30-second chair stand test (30-s CST), 4 × 10 m fast-paced walk test (40 m FPWT) and a stair climb test. The aim of this study was to evaluate the reliability, validity and responsiveness of these performance-based measures to assess the ability to measure physical function in knee OA patients.METHODS: A prospective cohort study of 85 knee OA patients indicated for total knee arthroplasty (TKA) was performed. Construct validity and responsiveness were assessed by testing of predefined hypotheses. A subgroup (n = 30) underwent test-retest measurements for reliability analysis. The Oxford Knee Score, Knee injury and Osteoarthritis Outcome Score-Physical Function Short Form, pain during activity score and knee extensor strength were used as comparator instruments. Measurements were obtained at baseline and 12 months after TKA.RESULTS: Appropriate test-retest reliability was found for all three tests. Intraclass correlation coefficient (ICC) for the 30-s CST was 0.90 (95% CI 0.68; 0.96), 40 m FPWT 0.93 (0.85; 0.96) and for the 10-step stair climb test (10-step SCT) 0.94 (0.89; 0.97). Adequate construct validity could not be confirmed for the three tests. For the 30-s CST, 42% of the predefined hypotheses were confirmed; for the 40 m FPWT, 27% and for the 10-step SCT 36% were confirmed. The 40 m FPWT was found to be responsive with 75% of predefined hypothesis confirmed, whereas the responsiveness for the other tests could not be confirmed. For the 30 s CST and 10-step SCT, only 50% of hypotheses were confirmed.CONCLUSIONS: The three performance-based tests had good reliability, but poor construct validity and responsiveness in the assessment of function for the domains sit-to-stand movement, walking short distances and stair negotiation. The findings of the present study do not justify their use for clinical practice.LEVEL OF EVIDENCE: Level 1. Diagnostic study.",

keywords = "Functional outcome, Osteoarthritis, Performance-based measures, Total knee arthroplasty, Prospective Studies, Follow-Up Studies, Humans, Middle Aged, Osteoarthritis, Knee/diagnosis, Pain/surgery, Male, Exercise Test, Time Factors, Range of Motion, Articular, Female, Knee Joint/physiopathology, Surveys and Questionnaires, Arthroplasty, Replacement, Knee/standards, Severity of Illness Index, Reproducibility of Results, Walking, Aged, Pain Measurement, Walk Test, Preoperative Period",

author = "J.J. Tolk and R.P.A. Janssen and C.A.C. Prinsen and D.A.J.M. Latijnhouwers and {van der Steen}, M.C. and S.M.A. Bierma-Zeinstra and M. Reijman",

year = "2019",

month = sep,

doi = "10.1007/s00167-017-4789-y",

language = "English",

volume = "27",

pages = "2898--2909",

journal = "Knee Surgery, Sports Traumatology, Arthroscopy",

issn = "0942-2056",

publisher = "John Wiley and Sons Inc",

number = "9",

}

TY - JOUR

T1 - The OARSI core set of performance-based measures for knee osteoarthritis is reliable but not valid and responsive

AU - Tolk, J.J.

AU - Janssen, R.P.A.

AU - Prinsen, C.A.C.

AU - Latijnhouwers, D.A.J.M.

AU - van der Steen, M.C.

AU - Bierma-Zeinstra, S.M.A.

AU - Reijman, M.

PY - 2019/9

Y1 - 2019/9

N2 - PURPOSE: The Osteoarthritis Research Society International has identified a core set of performance-based tests of physical function for use in people with knee osteoarthritis (OA). The core set consists of the 30-second chair stand test (30-s CST), 4 × 10 m fast-paced walk test (40 m FPWT) and a stair climb test. The aim of this study was to evaluate the reliability, validity and responsiveness of these performance-based measures to assess the ability to measure physical function in knee OA patients.METHODS: A prospective cohort study of 85 knee OA patients indicated for total knee arthroplasty (TKA) was performed. Construct validity and responsiveness were assessed by testing of predefined hypotheses. A subgroup (n = 30) underwent test-retest measurements for reliability analysis. The Oxford Knee Score, Knee injury and Osteoarthritis Outcome Score-Physical Function Short Form, pain during activity score and knee extensor strength were used as comparator instruments. Measurements were obtained at baseline and 12 months after TKA.RESULTS: Appropriate test-retest reliability was found for all three tests. Intraclass correlation coefficient (ICC) for the 30-s CST was 0.90 (95% CI 0.68; 0.96), 40 m FPWT 0.93 (0.85; 0.96) and for the 10-step stair climb test (10-step SCT) 0.94 (0.89; 0.97). Adequate construct validity could not be confirmed for the three tests. For the 30-s CST, 42% of the predefined hypotheses were confirmed; for the 40 m FPWT, 27% and for the 10-step SCT 36% were confirmed. The 40 m FPWT was found to be responsive with 75% of predefined hypothesis confirmed, whereas the responsiveness for the other tests could not be confirmed. For the 30 s CST and 10-step SCT, only 50% of hypotheses were confirmed.CONCLUSIONS: The three performance-based tests had good reliability, but poor construct validity and responsiveness in the assessment of function for the domains sit-to-stand movement, walking short distances and stair negotiation. The findings of the present study do not justify their use for clinical practice.LEVEL OF EVIDENCE: Level 1. Diagnostic study.

AB - PURPOSE: The Osteoarthritis Research Society International has identified a core set of performance-based tests of physical function for use in people with knee osteoarthritis (OA). The core set consists of the 30-second chair stand test (30-s CST), 4 × 10 m fast-paced walk test (40 m FPWT) and a stair climb test. The aim of this study was to evaluate the reliability, validity and responsiveness of these performance-based measures to assess the ability to measure physical function in knee OA patients.METHODS: A prospective cohort study of 85 knee OA patients indicated for total knee arthroplasty (TKA) was performed. Construct validity and responsiveness were assessed by testing of predefined hypotheses. A subgroup (n = 30) underwent test-retest measurements for reliability analysis. The Oxford Knee Score, Knee injury and Osteoarthritis Outcome Score-Physical Function Short Form, pain during activity score and knee extensor strength were used as comparator instruments. Measurements were obtained at baseline and 12 months after TKA.RESULTS: Appropriate test-retest reliability was found for all three tests. Intraclass correlation coefficient (ICC) for the 30-s CST was 0.90 (95% CI 0.68; 0.96), 40 m FPWT 0.93 (0.85; 0.96) and for the 10-step stair climb test (10-step SCT) 0.94 (0.89; 0.97). Adequate construct validity could not be confirmed for the three tests. For the 30-s CST, 42% of the predefined hypotheses were confirmed; for the 40 m FPWT, 27% and for the 10-step SCT 36% were confirmed. The 40 m FPWT was found to be responsive with 75% of predefined hypothesis confirmed, whereas the responsiveness for the other tests could not be confirmed. For the 30 s CST and 10-step SCT, only 50% of hypotheses were confirmed.CONCLUSIONS: The three performance-based tests had good reliability, but poor construct validity and responsiveness in the assessment of function for the domains sit-to-stand movement, walking short distances and stair negotiation. The findings of the present study do not justify their use for clinical practice.LEVEL OF EVIDENCE: Level 1. Diagnostic study.

KW - Functional outcome

KW - Osteoarthritis

KW - Performance-based measures

KW - Total knee arthroplasty

KW - Prospective Studies

KW - Follow-Up Studies

KW - Humans

KW - Middle Aged

KW - Osteoarthritis, Knee/diagnosis

KW - Pain/surgery

KW - Male

KW - Exercise Test

KW - Time Factors

KW - Range of Motion, Articular

KW - Female

KW - Knee Joint/physiopathology

KW - Surveys and Questionnaires

KW - Arthroplasty, Replacement, Knee/standards

KW - Severity of Illness Index

KW - Reproducibility of Results

KW - Walking

KW - Aged

KW - Pain Measurement

KW - Walk Test

KW - Preoperative Period

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U2 - 10.1007/s00167-017-4789-y

DO - 10.1007/s00167-017-4789-y

M3 - Article

C2 - 29128879

SN - 0942-2056

VL - 27

SP - 2898

EP - 2909

JO - Knee Surgery, Sports Traumatology, Arthroscopy

JF - Knee Surgery, Sports Traumatology, Arthroscopy

IS - 9

ER -

The OARSI core set of performance-based measures for knee osteoarthritis is reliable but not valid and responsive

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