Rheumatology Advance Access originally published online on January 13, 2004
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Rheumatology 2004; 43: 514-517
Rheumatology Vol. 43 No. 4 (c) British Society for Rheumatology 2004; all rights reserved
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The reliability, validity and responsiveness of an aggregated locomotor function (ALF) score in patients with osteoarthritis of the knee
Centre for Rehabilitation Science, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK
Correspondence to: C. J. McCarthy. E-mail: christopher.j.mccarthy{at}man.ac.uk
Objectives. The aggregated locomotor function (ALF) score, a simple measure of observed locomotor function, using timed walking, stairs and transfers, was developed and evaluated for intra-tester reliability, criterion-related validity and responsiveness in a sample of patients with knee osteoarthritis.
Methods. Patients with knee osteoarthritis (n = 214) were recruited for inclusion in a randomized controlled trial investigating two methods of exercise provision. Before treatment, patients completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Form 36 health survey (SF-36) questionnaires and were timed whilst performing an 8 m walk, ascending and descending a set of gymnasium stairs and completing a test of transferring in and out of a chair. A group of 15 patients also undertook a replicate test–retest reliability study of the above outcome measures. Standardized response means were calculated for the ALF, WOMAC and SF-36 from data from the clinical trial.
Results. The ALF takes 10 min to administer and demonstrated excellent intra-tester reliability, with excellent intra-class correlation coefficient (ICC) statistics (ICC2,k 0.99; 95% CI 0.98–0.99), and low standard error of measurement (0.86 s) and smallest detectable difference (9.5%) values. Criterion-related validity with the physical function dimensions of the WOMAC and SF-36 was good, with correlation coefficients of 0.59 and – 0.53 respectively. Standardized response means were higher for the ALF (0.49) than for both the WOMAC (0.39) and the SF-36 (0.12).
Conclusions. This work has demonstrated that the ALF can be used as a measure of physical function status and as a means of quantifying treatment response. The measure offers a simple and convenient outcome in the assessment and treatment of locomotor dysfunction. The ALF score is a reliable, valid and responsive outcome measure over 12 months and can be recommended for use in the evaluation of patients with knee osteoarthritis.
KEY WORDS: Locomotor function, Osteoarthritis, Validity, Reliability.
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