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Responsiveness and minimal important changes for the Knee Injury and Osteoarthritis Outcome Score in subjects undergoing rehabilitation after total knee arthroplasty

MONTICONE M; FERRANTE S; SALVADERI S; MOTTA A; CERRI C
AM J PHYS MED REHABIL , 2013, vol. 92, n° 10, p. 864-870
Doc n°: 168720
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1097/PHM.0b013e31829f19d8
Descripteurs : DE561 - TRAITEMENT CHIRURGICAL - GENOU

The aim of this study was to evaluate the responsiveness and minimal
important changes for the Knee Injury and Osteoarthritis Outcome Score (KOOS) in
subjects undergoing rehabilitation after total knee arthroplasty. DESIGN: At the
beginning and end of a rehabilitation program, 148 patients completed the KOOS. A
global perception of change scale was also completed at the end of the program
and collapsed to produce a dichotomous outcome (improved vs. stable).
Responsiveness was assessed on the KOOS subscales and calculated by distribution
methods (effect size; standardized response mean). The minimal important changes
of the KOOS subscales were assessed using anchor-based methods (receiver
operating characteristic curves) to compute the best cutoff levels between the
improved and stable subjects. RESULTS: The effect sizes ranged from 0.83 to 1.35,
and the standardized response means ranged from 0.76 to 1.22. The receiver
operating characteristic analyses revealed an area under the curve of 0.89, 0.88,
0.94, 0.93, and 0.85 for the Pain, Symptoms, Activities of Daily Living,
Sport/Recreation, and Quality of Life subscales, respectively, showing
discriminative capacities; the minimal important changes were 16.7 for Pain
(sensitivity: 83%; specificity: 82%), 10.7 for Symptoms (80%; 80%), 18.4 for
Activities of Daily Living (82%; 82%), 12.5 for Sport/Recreation (96%; 78%), and
15.6 for Quality of Life (88%; 67%). CONCLUSIONS: The KOOS was sensitive in
detecting clinical changes. The authors recommend taking the minimal important
changes provided into account when assessing patient improvement or planning
studies in this clinical context.

Langue : ANGLAIS

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