Optimal cut-off scores of performance-based tests of physical function to discriminate disease severity in patients with knee osteoarthritis

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2025-05-08 DOI:10.1016/j.knee.2025.04.019

Gulsah Ozsoy , Muhammed Ihsan Kodak , Caner Kararti , Fatih Ozyurt , Seyde Busra Kodak , Basak Cigdem Karacay , Ismail Ozsoy

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引用次数: 0

Abstract

Background

A set of physical tests representing typical activities relevant to persons with knee osteoarthritis (KOA) is recommended by the Osteoarthritis Research Society International (OARSI). The objective of this study was to designate the cut-off values for OARSI-recommended performance-based tests to better discriminate disease severity in patients with KOA.

Methods

As recommended by the OARSI, we conducted the 30-s chair stand test (30-s CST), 40-m fast-paced walk test (40-m FPWT), stair climb test (SCT), 6-min walk test (6MWT), and timed up and go test (TUG). To investigate the discriminative power of the performance test scores using the Kellgren–Lawrence (K-L) grading system, receiver operating characteristic (ROC) curve analysis was performed. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to assess self-administered health status.

Results

Forty-eight patients with bilateral KOA were included this study. The area under the curves for four of the five performance tests (30-s CST, six-step SCT, 40-m FPWT, and TUG) had acceptable discrimination (0.753–0.793), while the 6MWT had excellent discrimination (0.860). The stepwise multiple regression analysis demonstrated that 6MWT and 30-s CST were significant and independent determinants of WOMAC score, explaining 48% of the variance (P < 0.001).

Conclusion

The OARSI performance tests can discriminate disease severity in individuals with KOA. The 6MWT has the highest level of discriminative validity among all. In addition, despite the correlation between all five tests and the WOMAC score, 6MWT and 30-s CST are independent and significant determinants of the WOMAC.

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基于性能的身体功能测试的最佳截止分数，以区分膝关节骨关节炎患者的疾病严重程度

国际骨关节炎研究学会（OARSI）推荐了一套代表膝关节骨关节炎（KOA）患者典型活动的身体检查。本研究的目的是指定oarsi推荐的基于性能的测试的临界值，以更好地区分KOA患者的疾病严重程度。方法采用OARSI推荐的30秒站立椅测试（30-s CST）、40米快节奏步行测试（40-m FPWT）、爬楼梯测试（SCT）、6分钟步行测试（6MWT）和计时行走测试（TUG）。采用Kellgren-Lawrence （K-L）评分系统，采用受试者工作特征（ROC）曲线分析，探讨绩效测试分数的判别能力。使用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评估自我管理的健康状况。结果48例双侧KOA患者纳入本研究。5项性能测试（30秒CST、6步SCT、40米FPWT和TUG）中4项的曲线下面积判别可接受（0.753-0.793），而6MWT具有极好的判别（0.860）。逐步多元回归分析表明，6MWT和30-s CST是WOMAC评分的显著独立决定因素，解释了48%的方差(P <；0.001)。结论OARSI性能试验可区分KOA患者的疾病严重程度。6MWT的判别效度最高。此外，尽管所有五项测试与WOMAC评分之间存在相关性，但6MWT和30-s CST是WOMAC的独立且重要的决定因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.