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

H J Bieleman, M F Reneman, Miriam van Ittersum, Cees van der Schans, J W Groothoff, F G J Oosterveld

Research output: Contribution to journalArticleAcademicpeer-review

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 rho 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 > or =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.

Original languageEnglish
Pages (from-to)345-353
JournalJournal of occupational rehabilitation
Volume19
Issue number4
DOIs
Publication statusPublished - Dec 2009

Keywords

  • elderly people
  • cross-sectional studies
  • female
  • humans
  • male
  • middle aged
  • hip
  • knee
  • predictive value of tests
  • self concept
  • severity of illness index
  • work capacity evaluation
  • evaluation studies
  • multicenter study
  • research support, non-U.S. Gov't
  • osteoarthritis

Cite this

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title = "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",
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 rho 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 > or =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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author = "Bieleman, {H J} and Reneman, {M F} and {van Ittersum}, Miriam and {van der Schans}, Cees and Groothoff, {J W} and Oosterveld, {F G J}",
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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. / Bieleman, H J; Reneman, M F; van Ittersum, Miriam; van der Schans, Cees; Groothoff, J W; Oosterveld, F G J.

In: Journal of occupational rehabilitation, Vol. 19, No. 4, 12.2009, p. 345-353.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Self-reported functional status as predictor of observed functional capacity in subjects with early osteoarthritis of the hip and knee

T2 - a diagnostic study in the CHECK cohort

AU - Bieleman, H J

AU - Reneman, M F

AU - van Ittersum, Miriam

AU - van der Schans, Cees

AU - Groothoff, J W

AU - Oosterveld, F G J

N1 - References

PY - 2009/12

Y1 - 2009/12

N2 - 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 rho 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 > or =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.

AB - 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 rho 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 > or =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.

KW - elderly people

KW - cross-sectional studies

KW - female

KW - humans

KW - male

KW - middle aged

KW - hip

KW - knee

KW - predictive value of tests

KW - self concept

KW - severity of illness index

KW - work capacity evaluation

KW - evaluation studies

KW - multicenter study

KW - research support, non-U.S. Gov't

KW - osteoarthritis

KW - ouderen

KW - functionele capaciteit evaluatie

KW - knieën

KW - heupen

KW - osteoartritis

KW - gezondheidstoestand

KW - middelbare leeftijd

KW - mannen

KW - vrouwen

KW - onderzoek

KW - zelfrapportage

U2 - 10.1007/s10926-009-9189-9

DO - 10.1007/s10926-009-9189-9

M3 - Article

VL - 19

SP - 345

EP - 353

JO - Journal of occupational rehabilitation

JF - Journal of occupational rehabilitation

SN - 1053-0487

IS - 4

ER -