Journal article
Impact of context specificity on response to the shortened WOMAC function scale in patients undergoing total knee arthroplasty
Archives of Physical Medicine and Rehabilitation, Vol.105(9), pp.1725-1732
2024
PMID: 38723858
Abstract
Objective
To determine, in patients undergoing total knee arthroplasty (TKA), whether increasing context specificity of selected items of the shortened version of the Western Ontario and McMaster Universities Osteoarthritis Index function (WOMAC-F) scale (ShortMAC-F) (i) enhanced the convergent validity of the ShortMAC-F with performance-based mobility measures and (ii) impacted on mean scale score, structural validity, reliability, and interpretability.
Design
Secondary analysis of randomized clinical trial data.
Setting and Participants
Patients undergoing TKA (n=114).
Interventions
Not applicable.
Main Outcome Measures
The ShortMAC-F was modified by specifying the “ascending stairs” and “rising from sitting” items to enquire about difficulty in performing the tasks without reliance on compensatory strategies, while the modified “level walking” item enquired about difficulty in walking 400 meters. Before and 12 weeks after TKA, patients completed the WOMAC-F, modified ShortMAC-F, knee pain scale, sit-to-stand test, fast gait speed test, and stair-climb test. Interpretability was evaluated by calculating anchor-based substantial clinical benefit (SCB) estimates.
Results
The modified ShortMAC-F correlated significantly more strongly than ShortMAC-F or WOMAC-F with pooled performance measures (differences in correlation values, 0.12-0.14). Increasing item context specificity of the ShortMAC-F did not influence its psychometric properties of unidimensionality (comparative fit and Tucker-Lewis indices >0.95; root mean square error of approximation, 0.05-0.08), reliability (Cronbach alpha, 0.75-0.83), correlation with pain intensity (correlation values, 0.48-0.52), and SCB estimates (16 percentage points); however, it resulted in lower mean score (4.5-4.8 points lower).
Conclusions
The modified ShortMAC-F showed sufficient measurement properties for clinical application, and it seemed more adept than WOMAC-F at correlating with performance-based measures in TKA.
Details
- Title
- Impact of context specificity on response to the shortened WOMAC function scale in patients undergoing total knee arthroplasty
- Authors
- Yong-Hao Pua (Corresponding Author) - Singapore General HospitalSamantha Shi-Man Koh - Singapore General HospitalBerend Terluin - Vrije Universiteit AmsterdamEe-Lin Woon - Singapore General HospitalEleanor Shu-Xian Chew - Singapore General HospitalSeng-Jin Yeo - Singapore General HospitalJerry Yongqiang Chen - Singapore General HospitalLincoln Ming Han Liow - Singapore General HospitalRoss Clark - University of the Sunshine Coast, Queensland, School of Health - Sports & Exercise ScienceJulian Thumboo - Duke-NUS Medical School
- Publication details
- Archives of Physical Medicine and Rehabilitation, Vol.105(9), pp.1725-1732
- Publisher
- Elsevier Inc
- Date published
- 2024
- DOI
- 10.1016/j.apmr.2024.05.005
- ISSN
- 1532-821X
- PMID
- 38723858
- Organisation Unit
- Healthy Ageing Research Cluster; School of Health - Sports & Exercise Science
- Language
- English
- Record Identifier
- 991024496402621
- Output Type
- Journal article
Metrics
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