Avaliação funcional do joelho em portadores da síndrome da dor femoropatelar (SDFP): comparação entre as escalas KOS e IKDC

Abstract

Introduction and objective: Many instruments have been proposed for the knee assessment, making its choice often difficult. Among these instruments, we can mention the Knee Injury and Osteoarthritis Outcome Score (KOS) and the International Knee Documentation Committee (IKDC) scales; however, it is unclear which of them would be better to evaluate the knee of subjects with patellofemoral pain syndrome (PFPS). The objective of this study was to compare the KOS and IKDC scales evaluation to verify which of them would be more appropriate to identify impairment in patients with PFPS. Methods: The study included 31 PFPS subjects, aged between 18 and 39 years (24.29 ± 4.09); 27 subjects were female and 4 were male. All subjects were submitted to KOS and IKDC scales on the two occasions. The second application served as reliability evidence (PCKOS and PCIKDC).The analysis of statistical correlation between the scales was done with the Spearman and Wilcoxon tests, considering significant p < 0.05. Results: The Spearman correlation test presented strong correlation between KOS and PCKOS (r = 0.99, p < 0.001) and IKDC and PCIKDC (r = 0.96, p < 0.001). There was a weak correlation between KOS and IKDC (r = 0.46, p < 0.01) and PCKOS and PCIKDC (r = 0.55, p < 0.002). The Wilcoxon test revealed differences between KOS and IKDC (p < 0.001) and between PCKOS and PCIKDC (p < 0.001). There was equality between KOS and PCKOS (p > 0.10) and difference between IKDC and PCIKDC (p < 0.02). Conclusion: The KOS and IKDC scales were reliable during the application in patients with PFPS, where the KOS received greater reliability when compared to the IKDC.

The measurement properties of the IKDC-subjective knee form

“…The hypotheses were primarily correlations to other PROMs, e.g., Cincinnati score, the Lysholm score and the WOMAC score (Supplementary File 2). Of these, five studies had scores of “good” [7, 8, 20, 29, 50], and five studies had scores of “fair” [3, 8, 9, 27, 28, 38], mainly due to “vague hypothesis” or “moderate sample size.” Six studies had scores of “poor” for the methodological quality [1, 14, 21, 22, 42, 43] due to “no description of the constructs measured by the comparator instrument,” “no measurement properties reported on comparator instrument,” “unclear what was expected from hypothesis,” or “unclear what was expected regarding correlations or differences.” A positive rating for the results was given when 75 % of the hypotheses were confirmed [44]. There were more than 75 % confirmed hypotheses in nine studies (of which two had the methodological score of “good,” four of “fair” and three of “poor”) [1, 3, 9, 14, 20, 27, 29, 42], and fewer than 75 % confirmed hypotheses in four studies (of which three had the methodological score of “good” and one of “fair”) [7, 8, 28, 50].…”

“…The 12 studies reporting on reliability [9, 12–14, 16, 20, 23, 27, 35, 37, 43, 50] had scores of “good” to “poor” for methodological quality. The reason for a “poor” score [13, 23, 35, 37] included “small sample size,” “test conditions NOT similar for both measurements,” and “no ICC, Spearman, or Pearson test.” The ICC ranged from 0.87 to 0.98, which was considered adequate (>0.70) [44].…”

“…A total of 16 studies reported on hypothesis testing as part of construct validity [1, 3, 7–9, 14, 20–22, 27–29, 38, 42, 43, 50]. The hypotheses were primarily correlations to other PROMs, e.g., Cincinnati score, the Lysholm score and the WOMAC score (Supplementary File 2).…”

“…Of these, five studies had scores of "good" [7,8,20,29,50], and five studies had scores of "fair" [3,8,9,27,28,38], mainly due to "vague hypothesis" or "moderate sample size." Six studies had scores of "poor" for the methodological quality [1,14,21,22,42,43] due to "no description of the constructs measured by the comparator instrument," "no measurement properties reported on comparator instrument," "unclear what was expected from hypothesis," or "unclear what was expected regarding correlations or differences." A positive rating for the results was given when 75 % of the hypotheses were confirmed [44].…”

Utilização clínica de testes e escalas funcionais: uma entrevista com Fisioterapeutas

“…6,7 As escalas funcionais são instrumentos em formato de questionário que coletam informações autorrelatadas pelo paciente sobre suas atividades de vida diária ou prática esportiva. 8 O objetivo é identificar medidas subjetivas conforme a percepção do paciente e mensurar o impacto da lesão em sua função diária. É comum que seja avaliada a dor para realização de atividades rotineiras, como sentar e levantar, agachar, subir escadas, gestos específicos do esporte entre outras movimentações.…”