Validity, reliability, and comparison of the WOMAC osteoarthritis index and Lequesne algofunctional index in Turkish patients with hip or knee osteoarthritis

Abstract

To assess validity and reliability of the Western Ontario and McMaster Universities (WOMAC) osteoarthritis (OA) index and Lequesne algofunctional index in Turkish patients with hip or knee OA and to compare the results of the instruments for these two particular sites of involvement. Two disease-specific instruments: WOMAC LK 3.1 and Lequesne indices were administered to 117 outpatients with OA (44 hip and 73 knee) living in Turkey. These indices were administered twice 7-10 days apart to ensure the test-retest reliability. All patients were asked to reply a generic health-related quality-of-life instrument (Short Form-36, SF-36) and a structured interview assessing demographic and other characteristics. Internal consistency and reliability was evaluated by Cronbach's alpha and intra-class correlation coefficients (ICC). Construct validity was tested by correlating the WOMAC or Lequesne with each other, and also with SF-36 and visual analog scale (VAS). The Cronbach's alphas of the WOMAC and Lequesne subscales were ranged 0.78-0.95 and 0.51-0.85 for hip and 0.78-0.94 and 0.61-0.71 for knee OA, respectively. Test-retest reliability of the WOMAC and Lequesne subscales yielded ICCs of 0.77-0.94 and 0.51-0.85 for hip and 0.80-0.98 and 0.61-0.71 for knee OA, respectively. WOMAC and Lequesne showed moderate-good correlations between comparable subscales of SF-36 (physical functioning and bodily pain) and weak-moderate correlations between VAS. All subscales and total WOMAC had better internal consistency and more satisfactory concurrent validity compared with Lequesne. Our results indicated that WOMAC is a more reliable index for use in Turkish patients with hip or knee OA than Lequesne.

Impact of Rehabilitation on Health Related Quality of Life in Patients with Hip Osteoarthritis

“…Similar studies demonstrated serious disability in their study populations with total Lequesne scores that ranged from 10.51 to 13.67 (11,14,17,18). In our study, the worst score for the Lequesne index was in the ADL domain; this was also reported in the study by Konstantinidis et al (11).…”

“…In our study, the worst score for the Lequesne index was in the ADL domain; this was also reported in the study by Konstantinidis et al (11). However, in the studies by Basaran et al (18) and Nadrian et al (17), the pain domain showed the worst score. After rehabilitation, statistically significant improvements were observed in all domains of the Lequesne index.…”

“…The education level of our patients was, on average, higher than that of patients in other studies; the majority of the populations from those studies had completed up to primary school (14,15,17) or were illiterate (17,18). The average duration of hip OA in our group of patients was 4.42 ± 2.5 years, which was similar to that reported by Boutron et al (5.4 ± 4.8 years; n=1581) and other studies (15,17,18).Before rehabilitation, our patients showed low baseline. For the SF-36, the RE and RP domains achieved the largest improvement, while the GH domain showed the smallest improvement.…”

“…Moreover, we found significant positive correlations between the duration of disease and all of the Lequesne subscales before and after rehabilitation, while Nadrian et al (17) observed a significant positive correlation between the pain domain and the total Lequesne score and also between the Lequesne distance and ADL subscale scores. In a study by Basaran et al (18), age, education and the duration of the disease did not show significant correlations with all of the Lequesne subscales.…”

“…The majority were women, corresponding to the sex distribution of cohorts from other studies (7,(14)(15)(16)(17)(18)(19). The education level of our patients was, on average, higher than that of patients in other studies; the majority of the populations from those studies had completed up to primary school (14,15,17) or were illiterate (17,18). The average duration of hip OA in our group of patients was 4.42 ± 2.5 years, which was similar to that reported by Boutron et al (5.4 ± 4.8 years; n=1581) and other studies (15,17,18).Before rehabilitation, our patients showed low baseline.…”