Self-Reported Functional Status as Predictor of Observed Functional Capacity in Subjects with Early Osteoarthritis of the Hip and Knee: A Diagnostic Study in the CHECK Cohort |
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Authors: | H J Bieleman M F Reneman M W van Ittersum C P van der Schans J W Groothoff F G J Oosterveld |
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Institution: | (1) Expertise Center Health, Social Care and Technology, Saxion University of Applied Sciences, P.O. Box 70.000, 7500 KB Enschede, The Netherlands;(2) Center for Rehabilitation, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands;(3) Research and Innovation Group in Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands;(4) Graduate School for Health Research, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;(5) Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands |
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Abstract: | Objectives Patients with hip or knee osteoarthritis (OA) may experience functional limitations in work settings. In the Cohort Hip and
Cohort Knee study (CHECK) physical function was both self-reported and measured performance-based, using Functional Capacity
Evaluation (FCE). Relations between self-reported scores on SF-36 and WOMAC (Western Ontario and McMaster Arthritis Index,
function scales) and FCE performance were studied, and their diagnostic value for clinicians in predicting observed physical
work limitations was assessed. Methods Ninety-two subjects scored physical function on SF-36 (scale 0–100, 100 indicating the best health level) and WOMAC (scale
0–68, 68 indicates maximum restriction) and performed the FCE. Correlations were calculated between all scores. Cross-tables
were constructed using both questionnaires as diagnostic tests to identify work limitations. Subjects lifting <22.5 kg on
the FCE-test ‘lifting-low’ were labeled as having physical work limitations. Diagnostic aspects at different cut-off scores
for both questionnaires were analysed. Results Statistically significant correlations (Spearman’s ρ 0.34–0.49) were found between questionnaire scores and lifting and carrying
tests. Results of a diagnostic cross-table with cut-off point <60 on SF-36 ‘physical functioning’ were: sensitivity 0.34,
specificity 0.97 and positive predictive value (PV+) 0.95. Cut-off point ≥21 on WOMAC ‘function’ resulted in sensitivity 0.51,
specificity 0.88 and PV+ 0.88. Conclusion Low self-reported function scores on SF-36 and WOMAC diagnosed subjects with limitations on the FCE. However, high scores
did not guarantee performance without physical work limitations. These results are specific to the tested persons with early
OA, in populations with a different prevalence of limitations, different diagnostic values will be found. FCE may be indicated
to help clinicians to assess actual work capacity. |
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