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Clinimetric properties of WOMAC index in Greek knee osteoarthritis patients: comparisons with both self-reported and physical performance measures

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Abstract

This observational study aimed to examine the clinimetric properties of the Greek for Greece translation of the Western Ontario and McMaster Osteoarthritis Index (WOMAC®). One hundred and twenty-three patients with knee osteoarthritis (mean age 69.5 years) participated in the study. An extensive reliability study was carried out to assess WOMAC’s internal consistency and repeatability (8-day interval). In addition, we examined the construct (convergent, nomological and known-groups) and criterion-related (concurrent and predictive) validity of the index against both self-report [SF-36 and combined visual analog/faces pain scale-revised (VAS/FPS-R)] and physical performance measures [timed up and go test (TUG)]. The internal consistency of the WOMAC subscales ranged from high (0.804) to excellent (0.956). Intra-class correlation coefficients for test–retest reliability were excellent, ranging from 0.91 to 0.95. Partial correlation analysis, adjusted for age and use of an assistive device, showed that WOMAC scores were significantly associated with all validation criteria, presenting fair to strong (−0.33 to −0.86) correlation coefficients. WOMAC-function was strongly associated with SF36-function (−0.86) and TUG (0.71), WOMAC-pain to VAS/FPS-R (0.71) and SF36-pain (−0.67). Of all WOMAC outcomes, stiffness subscale had the lowest, though still significant, correlations with all validation criteria. Multiple linear regression analyses indicated that WOMAC-function was a significant factor for TUG, WOMAC-pain for VAS/FPS-R and both for SF36-function and SF36-pain. The WOMAC LK3.1 Greek for Greece Index is a reliable and valid assessment tool for the evaluation of individuals with knee osteoarthritis, showing excellent reliability and significant validity properties.

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Acknowledgments

The authors would like to thank Philip Lees, Technical Editor of the Hellenic Journal of Cardiology, for his invaluable editorial assistant with the English text.

Conflict of interest

Nicholas Bellamy is the registered copyright and registered trademark holder of the WOMAC® Index. None of the other authors had any conflict of interest in relation to this study.

Author information

Authors and Affiliations

  1. Physiotherapy Department, Technological Educational Institute of Athens, 24 Mitrodorou St., 10441, Athens, Greece

    George Papathanasiou, Sophia Stasi & Ioanna Roussou

  2. Resident of A΄ Orthopaedic Department, General Hospital of Athens “G. Gennimatas”, 154 Mesogion Ave., 11527, Athens, Greece

    Leon Oikonomou

  3. General Department of Mathematics, Technological Educational Institute of Athens, Ag. Spyridonos St., 12210, Athens, Greece

    Effie Papageorgiou

  4. 2nd University Orthopaedic Department, Konstantopoulio Hospital, 3-5 Agias Olgas St., 14388, N. Ionia, Athens, Greece

    Efstathios Chronopoulos

  5. 1st Orthopaedic Department, General Hospital of Attica “KAT”, 2 Nikis str., 14561, Kifissia, Athens, Greece

    Nectarios Korres

  6. School of Medicine, Royal Brisbane and Women’s Hospital, The University of Queensland, Edith Cavell Building (Room 127), Herston, QLD, 4029, Australia

    Nicholas Bellamy

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  1. George Papathanasiou
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Correspondence to George Papathanasiou.

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Papathanasiou, G., Stasi, S., Oikonomou, L. et al. Clinimetric properties of WOMAC index in Greek knee osteoarthritis patients: comparisons with both self-reported and physical performance measures. Rheumatol Int 35, 115–123 (2015). https://doi.org/10.1007/s00296-014-3043-x

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  • DOI: https://doi.org/10.1007/s00296-014-3043-x

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