Oa is viewed today as the clinical and pathological outcome of a range of disorders that result in degenerative, progressive structural, and functional failure of synovial joints. The results thus equal standardized womac scores standardization of womac scores is by division of the scale sum score by the number of items 2. These observations suggest the need for care in interpreting womac scores as just a measure of. Womac index was developed for hip and knee osteoarthritis, however it has. Pain, other symptoms, function in daily living adl, function in sport and recreation. Higher scores represent greater problems with pain and function. However, the womac function subscale appeared to be less responsive than the numerical scales for both knee and hip, with srms ranging from 0. A short version of the western ontario and mcmaster universities osteoarthritis index womac function scale has recently been developed to enhance the applicability of the scale in routine practice and clinical research for patients with hip and knee osteoarthritis. Osteoarthritis of the knee is the most common chronic joint disease that involves middle aged and elderly persons. The therapeutic effect of intraarticular normal saline injections for knee osteoarthritis a metaanalysis of evidence level 1 studies bryan m. P womac total score, international knee documentation committee score, lequesne score, standardized mean difference 1. The womac takes approximately 12 minutes to complete, and can be taken on paper, over the telephone or. The western ontario and mcmaster universities womac osteoarthritis oa index is a tested questionnaire to assess symptoms and physical functional disability in patients with oa of the knee and the hip. Pdf validation of the spanish version of the womac.
The index is selfadministered and assesses the three dimensions of pain, disability and joint stiffness in knee and hip osteoarthritis using a. The western ontario and mcmaster universities osteoarthritis index womac name. Periosteal electrical dry needling as an adjunct to exercise. Knee injury and osteoarthritis outcome score koos questionnaire developed as an extension of the womac index questions from the womac index version 3. Cole,z md, mba investigation performed at the rush university medical. In 1988, bellamy and coworkers 3 first published the womac, a 24item, conditionspecific questionnaire to be used for hip and knee osteoarthritis. The western ontario and mcmaster universities osteoarthritis index womac is a widely used measure of symptoms and physical disability originally developed for people with osteoarthritis oa of the hip andor knee 1, 2. The questionnaire contains 24 questions, targeting areas of pain, stiffness and. The koos is selfadministered and assesses five outcomes. There are different clinical instruments to quantify the health status of patients with knee osteoarthritis and one example is the womac score that has been translated and adapted into different languages. The womac knee and hip and the auscan hand oa indices n. Imaging of knee osteoarthritis open access journal. Roos em, roos hp, lohmander ls, ekdahl c, beynnon bd.
The western ontario and mcmaster universities osteoarthritis. Dextrose and morrhuate sodium injections prolotherapy. Hip disability and osteoarthritis outcome score womac. Pdf this study validates the shortform womac function scale for assessment of conservative treatment of osteoarthritis of the knee. Mt and exercise versus mt and exercise plus electrical dry needling. Data were extracted on the version used, score range, analysis and results of the womac, and whether these details were clearly reported.
Womac pain questions activities in order of affirmation as the pain score. Guideline for the management of knee and hip osteoarthritis. The study showed that acupressure was able to correct the womac and pain scores in long and short term and improve physical function in short term in patients with knee osteoarthritis. Pdf validation of chinese western ontario and mcmaster. Arthritis index womac questionnaire 18,19 were fulfilled by all patients. Knee injury and osteoarthritis outcome score koosvalidation of a swedish version.
Western ontario and mcmaster universities osteooarthritis. Validity and reliability of swedish womac osteoarthritis index. The knee injury and osteoarthritis outcome score koos is a questionnaire designed to assess short and longterm patientrelevant outcomes following knee injury. The measure was developed to evaluate clinically important, patientrelevant changes in health status resulting from treatment interventions. Jan 23, 2012 the aims of the present study were first to detect mcid for womac in a moroccan population, and second, to identify the best pretreatment predictors on the change of health after treatment by nonspecific, nonsteroidal antiinflammatory drugs nsaids, and to evaluate whether the predictors were dependent on the choice of the response criterion. The western ontario and mcmaster universities osteoarthritis index. Comparison of reliability and responsiveness of patient. Guideline for the management of knee and hip osteoarthritis iii second edition about this guideline the royal australian college of general practitioners racgp first developed guidelines for the nonsurgical management of hip and knee osteoarthritis in 2009. Responsiveness of the womac osteoarthritis index as.
It has been validated in patients with osteoarthritis oa of the hip or knee in a paperbased. Comprehensive assessment of patients with osteoarthritis oa of the legs includes both measurement of impairmentfor example, symptoms and disability, and health related quality of life. Knee disability and osteoarthritis outcome score koos. Knee osteoarthritis koa is the most common joint disease. Bellamy views in the literature to the use of womac in validation studies, comparative studies against other health status measures, and in various clinical research and clinical practice settings to evaluate patient outcomes 7. Knee injury and osteoarthritis outcome score koos knee injury and osteoarthritis outcome score koos development of a selfadministered outcome measure. Correlation of knee ultrasonography and western ontario. If we required only one activity with moderate pain, the number increased to 9 by 9%, and further to 161 by. Womac, eq5d and knee society score thresholds for treatment. The womac index is a diseasespecific, tridimensional selfadministered questionnaire, for assessing health status and health outcomes in osteoarthritis of the knee andor hip. The western ontario and mcmaster universities osteoarthritis index womac. Western ontario and mcmaster universities osteooarthritis index. It has been well documented that the womac is reliable, valid, and responsive to change in patients with hip and knee oa.
Secondary outcomes included knee pain intensity as measured by the numeric pain rating scale nprs, all. Koos was developed and is validated for several cohorts of younger andor more active patients with knee injury andor knee osteoarthritis 6,7,9. Periosteal electrical dry needling as an adjunct to. The womac captures more than just knee or hip pain and dysfunction, and is clearly in. Universities womac osteoarthritis oa index in physiotherapy outpatient practice in turkey. Efficacy of plateletrich plasma in the treatment of knee. The severity of koa, based on articular cartilage thickness, showed good correlation with the pain and stiffness subclasses of the womac score. The program in that study was based on the same theoretical framework as the asmp, but included content that was specifically tailored to patients with knee osteoarthritis. Extended report evaluation of womac 20, 50, 70 response. Mcmaster universities osteoarthritis index womac pain changes over 24 months in those with knee oa 24. Validation of chinese western ontario and mcmaster universities osteoarthritis index womac in patients scheduled for total knee replacement. Problems persist in reporting of methods and results for. Pdf comparative validation of the womac osteoarthritis and.
Questionnaires in patients with knee osteoarthritis. The western ontario mcmaster universities osteoarthritis index womac, visual analog scale, and lequesnes functional index were used to evaluate pain, stiffness, and physical function of knee. Womac has been used extensively in research studies, undergone rigorous psychometric validation, and is frequently utilized in many clinical trials. Validation of a numerical rating scale to assess functional. Oa occurs when the dynamic equilibrium between the breakdown. Scale scores are calculated which range from 0 best score to 10 worst score. The knee injury and osteoarthritis outcome score koos. Correlation of knee ultrasonography and western ontario and. Pdf validation of the shortform womac function scale for the. Womac index was developed for hip and knee osteoarthritis, however it has been used with other rheumatic conditions such as.
If we required a score of or 4 and at least 2 activities with at least moderate pain, we found 128 of these subjects were eligible. For each situation, please enter the amount of pain you have experienced in the past 48 hours. The diseasespecific questionnaire, western ontario and mcmaster universities osteoarthritis index womac, is the most widely used instrument to evaluate symptomatology and function in patients with hip or knee osteoarthritis oa 15. Please rate the activities in each category according to the following scale of difficulty. Clinically important improvement in the womac and predictor. Please describe the level of pain you have experienced in the past 48 hours for each one of your knees. Determinants of womac function, pain and stiffness scores. The scale scores as well as the composite score thus range from 0 to 10.
In the subset of oa patients, radiographic scores added little to the explained variance. Alternatively a visual analogue scale vas may be used ranging from 0 to 10. The goal of the present study was to validate this short form. Hip disability and osteoarthritis outcome score physiopedia objective the hip. The therapeutic effect of intraarticular normal saline. Please circle the appropriate rating for each item.
Two hundred thirtyfour subjects with chronic knee pain completed the womac pain survey. Western ontario and mcmaster universities osteoarthritis. Validation of a short form of the western ontario and. We adapted the womac for the italian language and tested its metric properties in 304 patients with symptomatic oa of the knee. Similarly, another study demonstrated a relationship between baseline cartilage volume and knee symptoms womac pain, stiffness and function scores, and a correlation between the loss of cartilage volume over 24 months and the worsening. The measure was developed to evaluate clinically important, patient. Since its development in 1982, the womac index has undergone several revisions and modifications. Knee injury and osteoarthritis outcome score koosdevelopment of a selfadministered outcome measure. Womac osteoarthritis index rozina and smith physical therapy.
Knee, osteoarthritis, womac, ultrasound background knee osteoarthritis koa is the most common joint. The womac westren ontario and mcmaster universities index is used to assess patients with osteoarthritis of the hip or knee using 24 parameters. Mcmaster osteoarthritis index womac please circle the. The index is selfadministered and assesses the three dimensions of pain, disability and joint stiffness in knee and hip osteoarthritis using a battery of 24 questions. There are multiple versions of the aims2, such as the aims2sf. Treatment of osteoarthritis of the knee, 2nd edition.
Womac osteoarthritis index south ga spine, joint and. Validation studies reliability, validity, responsiveness orthopaedic validation study. Validation of the spanish version of the womac questionnaire for patients with hip or knee osteoarthritis. Methods scales the western ontario and mcmaster university osteoarthritis index womac is a diseasespecific, selfadministered, health measure developed to study patients with osteoarthritis in the hip or knee. A popular patientreported outcome measure prom used for evaluation with hip and knee osteoarthritis is the western ontario and mcmaster universities osteoarthritis index womac. Reliability and validity of the western ontario and mcmaster. It was designed to provide a standardised assessment of selfreported health status while incorporating activities relevant to patients.
Since its conception, the womac has undergone several revisions and modifications, with the latest version womac 3. Similarly, for the 70% minimum clinically important response level, the definitions were. Toward a clinical definition of early osteoarthritis. To assess the evidence for the efficacy of the following interventions for improving clinical outcomes in adults with osteoarthritis oa of the knee. Our study aimed at developing clinical thresholds cutoff scores for the western ontario and mcmaster universities womac osteoarthritis index, eq5d and knee society score for discriminating between patients with and without treatment success following total knee arthroplasty tka. South georgia spine and joint center 202 south madison st. Despite being the leading cause of chronic disability in the elderly, there is no cure for oa, and the only established treatment for endstage oa is costly joint replacement surgery. Validation of a proposed womac short form for patients. The likert version of the womac is rated on an ordinal scale of 0 to 4, with. An extension of the western ontario and mcmaster universities osteoarthritis index. Knee injury and osteoarthritis outcome score koos validation and comparison to the womac in total knee replacement. Acceptability, reliability, validity and responsiveness of the turkish.
What womac pain score should make a patient eligible for a. The questionnaire also includes sections which ask respondents to rate their satisfaction and the impact of arthritis on each of these 12 areas. Sep 01, 2009 the womac was developed in the early 1980s as a diseasespecific measure for hip and knee osteoarthritis bellamy 2009. Treatment of osteoarthritis of the knee, 2nd edition summary. May 25, 2003 the knee injury and osteoarthritis outcome score koos is an extension of the western ontario and mcmaster universities osteoarthritis index womac.
Determinants of womac function, pain and stivness scores. Womac is a selfadministered health status measure that assesses the dimensions of pain, stiffness and function either separately or as an overall index in patients with oa of the hip or knee. The strongest predictor of womac abnormality in bivariate and multivariate analyses was the fatigue score, with correlations of 0. The following questions concern the amount of pain you are currently experiencing in your knees. The knee injury and osteoarthritis outcome score koos was developed as an extension of the womac osteoarthritis index with the purpose of evaluating shortterm and longterm symptoms and function in subjects with knee injury and osteoarthritis. Validity, reliability, and comparison of the womac osteoarthritis index and lequesne algofunctional index in turkish patients with hip or knee osteoarthritis. A composite score was calculated as the unweighted mean of the three scale scores. Reliability and validity of the western ontario and. Clinician researchers american college of rheumatology. The following is the table of contents from the womac 3. Knee injury and osteoarthritis outcome score koos patient. The primary outcome was relateddisability as assessed by the we stern ontario and mcmaster universities womac total score osteoarthritis index at 3 months. The secondary outcome measure was the knee pain scale and postprocedure opioid medication use and participant satisfaction. The original version contained 41 items in 5 domains.