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Protocol - Knee Injury and Osteoarthritis

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Protocol Name from Source:

Knee injury and Osteoarthritis Outcome Score (KOOS)

Availability:

Publicly available

Description:

A self-administered questionnaire consisting 42 Likert-style items in five subscales: Pain, Other Symptoms, Function in Daily Living (ADL), Function in Sport and Recreation (Sport/Rec), and Knee-Related Quality of Life (QOL). Appropriate for ages 13-79.

Scoring notes: The previous week is the time period considered when answering the questions. Standardized answer options are given (five Likert boxes), and each question is assigned a score from 0 to 4. A normalized score (100 indicating no symptoms and 0 indicating extreme symptoms) is calculated for each subscale (scoring instructions are available in a separate document named "[alink[4_KOOS_Scoring_2012.pdf|KOOS Scoring 2012.pdf]]")

Protocol:

INSTRUCTIONS: This survey asks for your view about your knee. This information will help us keep track of how you feel about your knee and how well you are able to perform your usual activities.

Answer every question by ticking the appropriate box, only one box for each question. If you are unsure about how to answer a question, please give the best answer you can.

Symptoms

These questions should be answered thinking of your knee symptoms during the last week.

S1. Do you have swelling in your knee?

[ ] Never

[ ] Rarely

[ ] Sometimes

[ ] Often

[ ] Always

S2. Do you feel grinding, hear clicking or any other type of noise when your knee moves?

[ ] Never

[ ] Rarely

[ ] Sometimes

[ ] Often

[ ] Always

S3. Does your knee catch or hang up when moving?

[ ] Never

[ ] Rarely

[ ] Sometimes

[ ] Often

[ ] Always

S4. Can you straighten your knee fully?

[ ] Always

[ ] Often

[ ] Sometimes

[ ] Rarely

[ ] Never

S5. Can you bend your knee fully?

[ ] Always

[ ] Often

[ ] Sometimes

[ ] Rarely

[ ] Never

Stiffness

The following questions concern the amount of joint stiffness you have experienced during the last week in your knee. Stiffness is a sensation of restriction or slowness in the ease with which you move your knee joint.

S6. How severe is your knee joint stiffness after first wakening in the morning?

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

S7. How severe is your knee stiffness after sitting, lying or resting later in the day?

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

Pain

P1. How often do you experience knee pain?

[ ] Never

[ ] Monthly

[ ] Weekly

[ ] Daily

[ ] Always

What amount of knee pain have you experienced the last week during the following activities?

P2. Twisting/pivoting on your knee

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

P3. Straightening knee fully

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

P4. Bending knee fully

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

P5. Walking on flat surface

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

P6. Going up or down stairs

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

P7. At night while in bed

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

P8. Sitting or lying

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

P9. Standing upright

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

Function, daily living

The following questions concern your physical function. By this we mean your ability to move around and to look after yourself. For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee.

A1. Descending stairs

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A2. Ascending stairs

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee.

A3. Rising from sitting

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A4. Standing

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A5. Bending to floor/pick up an object

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A6. Walking on flat surface

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A7. Getting in/out of car

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A8. Going shopping

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A9. Putting on socks/stockings

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A10. Rising from bed

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A11. Taking off socks/stockings

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A12. Lying in bed (turning over, maintaining knee position)

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A13. Getting in/out of bath

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A14. Sitting

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A15. Getting on/off toilet

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee.

A16. Heavy domestic duties (moving heavy boxes, scrubbing floors, etc.)

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A17. Light domestic duties (cooking, dusting, etc.)

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

Function, sports and recreational activities

The following questions concern your physical function when being active on a higher level. The questions should be answered thinking of what degree of difficulty you have experienced during the last week due to your knee.

SP1. Squatting

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

SP2. Running

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

SP3. Jumping

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

SP4. Twisting/pivoting on your injured knee

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

SP5. Kneeling

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

Quality of Life

Q1. How often are you aware of your knee problem?

[ ] Never

[ ] Monthly

[ ] Weekly

[ ] Daily

[ ] Constantly

Q2. Have you modified your life style to avoid potentially damaging activities?

to your knee?

[ ] Not at all

[ ] Mildly

[ ] Moderately

[ ] Severely

[ ] Totally

Q3. How much are you troubled with lack of confidence in your knee?

[ ] Not at all

[ ] Mildly

[ ] Moderately

[ ] Severely

[ ] Extremely

Q4. In general, how much difficulty do you have with your knee?

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

Thank you very much for completing all the questions in this questionnaire.

Personnel and Training Required

None

Equipment Needs

None

Requirements

Requirement CategoryRequired
Average time of greater than 15 minutes in an unaffected individualNo
Major equipmentNo
Specialized requirements for biospecimen collectionNo
Specialized trainingNo

Mode of Administration

Life Stage:

Adolescent, Adult, Senior

Specific Instructions:

At least 50% of items within each subscale need to be answered in order to calculate a score. This questionnaire can also be used to derive Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores.

Research Domain Information

Release Date:

July 2, 2018

Definition

A self-administered questionnaire to assess the patient's opinion about their knee and associated problems. Intended to be used for knee injury that can result in post-traumatic osteoarthritis (OA) as well as knee OA.

Purpose

Chronic inflammation of the knee or post-traumatic osteoarthritis (OA) can cause physical and emotional distress, result in limitations on functional ability and daily living activities, and can negatively impact an individual's quality of life.

Selection Rationale

The KOOS instrument demonstrates good test-retest reliability, content validity and internal consistency with adult and older adult populations.

Language

English

Standards

StandardNameIDSource

Process and Review

The Expert Review Panel has yet to review this measure.

Source

Roos, E.M., Roos, P.H., Lohmander, L.S., Ekdahl, C., Beynnon, B.D. (1998) Knee injury and Osteoarthritis Outcome Score (KOOS). Development of a self-administered outcome measure. J Orthop Sports Phys Ther, 78(2):88-96

Knee injury and Osteoarthritis Outcome Score (KOOS), English version LK1.0

General References

Ageberg, E., Forssblad, M., Herbertsson, P., & Roos, E. M. (2010). Sex differences in patient-reported outcomes after anterior cruciate ligament reconstruction: Data from the Swedish Knee Ligament Register. American Journal of Sports Medicine, 38, 1334-1342.

Alviar, M. J., Olver, J., Brand, C., Hale, T., & Khan, F. (2011). Do patient-reported outcome measures used in assessing outcomes in rehabilitation after hip and knee arthroplasty capture issues relevant to patients? Results of a systematic review and ICF linking process. Journal of Rehabilitation Medicine: Official Journal of the UEMS European Board of Physical and Rehabilitation Medicine, 43, 374-381.

Bellamy, N., Buchanan, W. W., Goldsmith, C. H., Campbell, J., & Stitt, L. W. (1988). Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. Journal of Rheumatology, 15, 1833-1840.

Collins, N. J., Prinsen, C.A., Christensen, R., Bartels, E.M., Terwee, C.B., Roos, E.M. (2016). Knee Injury and Osteoarthritis Outcome Score (KOOS): systematic review and meta-analysis of measurement properties. Osteoarthritis Cartilage, 24(8): 1317-1329.

Collins, N. J., Misra, D., Felson, D. T., Crossley, K. M., & Roos, E. M. (2011). Measures of knee function: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL), Lysholm Knee Scoring Scale, Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Activity Rating Scale (ARS), and Tegner Activity Score (TAS). Arthritis Care and Research;63(Suppl. 11), S208-S228.

Collins, N. J., & Roos, E. M. (2012). Patient-reported outcomes for total hip and knee arthroplasty: commonly used instruments and attributes of a "good" measure. Clinics in Geriatric Medicine, 28, 367-394.

Frobell, R. B., Svensson, E., Gothrick, M., & Roos, E. M. (2008). Self-reported activity level and knee function in amateur football players: The influence of age, gender, history of knee injury and level of competition. Knee Surgery, Sports Traumatology, Arthroscopy, 16, 713-719.

Garratt, A. M., Brealey, S., & Gillespie, W. J. (2004). Patient-assessed health instruments for the knee: A structured review. Rheumatology (Oxford), 43, 1414-1423.

Gudbergsen, H., Bartels, E. M., Krusager, P., Waehrens, E. E., Christensen, R., Danneskiold-Samsoe, B., & Bliddal, H. (2011). Test-retest of computerized health status questionnaires frequently used in the monitoring of knee osteoarthritis: a randomized crossover trial. BMC Musculoskeletal Disorders, 12, 190.

Nilsdotter, A. K., Toksvig-Larsen, S., & Roos, E. M. (2009). A 5 year prospective study of patient-relevant outcomes after total knee replacement. Osteoarthritis Cartilage, 17, 601-606.

Ostenberg, A., Roos, E., Ekdahl, C., & Roos, H. (2000). Physical capacity in female soccer players-does age make a difference? Advances in Physiotherapy, 2, 39-48.

Paradowski, P. T., Bergman, S., Sunden-Lundius, A., Lohmander, L. S., & Roos, E. M. (2006). Knee complaints vary with age and gender in the adult population. Population-based reference data for the Knee injury and Osteoarthritis Outcome Score (KOOS). BMC Musculoskeletal Disorders, 7, 38.

Rodriguez-Merchan, E. C. (2012). Knee instruments and rating scales designed to measure outcomes. Journal of Orthopaedics andTraumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology, 13, 1-6.

Roos, E., Engelhart, L., Ranstam, J., Anderson, A., Irrgang, J., Marx, R., . . . Davis, A. M. (2011). ICRS Recommendation Document: Patient-reported outcome instruments for use in patients with articular cartilage defects. Cartilage, 2, 122-136.

Roos, E. M., & Lohmander, L. S. (2003). Knee injury and Osteoarthritis Outcome Score (KOOS): From joint injury to osteoarthritis. Health and Quality of Life Outcomes, 1, 64.

Roos, E. M., Klassbo, M., & Lohmander, L. S. (1999). WOMAC osteoarthritis index. Reliability, validity, and responsiveness in patients with arthroscopically assessed osteoarthritis. Western Ontario and McMaster Universities. Scandinavian Journal of Rheumatolology, 28, 210-215.

Roos, E. M., Roos, H. P., & Lohmander, L. S. (1999). WOMAC Osteoarthritis Index-Additional dimensions for use in subjects with post-traumatic osteoarthritis of the knee. Western Ontario and McMaster Universities. Osteoarthritis Cartilage, 7, 216-221.

 Wright, R. W. (2009). Knee injury outcomes measures. Journal of the American Academy of Orthopaedic Surgeons, 17, 31-39

Protocol ID:

250401

Variables:

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