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

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

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.

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Acknowledgements

We would like to sincerely thank Christa van Doesburg, Hilke Cox and Mathias Mariam for their work in administrative and testing procedures.

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Authors and Affiliations

  1. Department of Orthopedic Surgery and Trauma, Máxima Medical Center, Postbus 90052, 5600 PD, Eindhoven, The Netherlands

    J. J. Tolk, R. P. A. Janssen, D. A. J. M. Latijnhouwers & M. Reijman

  2. Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam Public Health (APH) Research Institute, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands

    C. A. C. Prinsen

  3. Department of Orthopedic Surgery, Catharina Hospital Eindhoven, P.O. Box 1350, 5602 ZA, Eindhoven, The Netherlands

    M. C. van der Steen

  4. Department of General Practice, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands

    S. M. A. Bierma-Zeinstra

  5. Department of Orthopedic Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, Netherlands

    S. M. A. Bierma-Zeinstra & M. Reijman

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  1. J. J. Tolk
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  2. R. P. A. Janssen
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  3. C. A. C. Prinsen
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  5. M. C. van der Steen
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Contributions

JT and MR have contributed to the conception and design of the study and drafting of the article. CP provided methodological support. DL has contributed to collection and assembly of data. All authors have contributed to interpretation of the data, critically revising the article for important intellectual content and have approved the final version of the article.

Corresponding author

Correspondence to J. J. Tolk.

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Conflict of interest

All authors have no conflicts of interest to report.

Ethical review committee statement

The study has been performed in accordance with the ethical standards in the 1964 Declaration of Helsinki.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Tolk, J.J., Janssen, R.P.A., Prinsen, C.A.C. et al. The OARSI core set of performance-based measures for knee osteoarthritis is reliable but not valid and responsive. Knee Surg Sports Traumatol Arthrosc 27, 2898–2909 (2019). https://doi.org/10.1007/s00167-017-4789-y

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  • DOI: https://doi.org/10.1007/s00167-017-4789-y

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