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Abstract
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OBJECTIVE: This study aimed to cross-validate a previously developed knee osteoarthritis falls (KOAF) screening tool to distinguish between fallers and non-fallers in community-dwelling older adults with knee osteoarthritis (OA).
DESIGN: A cross-sectional survey study.
SETTING: Three independent orthopedic clinics.
PARTICIPANTS: Eighty-six older outpatients with knee OA (71 females, 15 males; mean age, 75.2 ± 6.2 years) participated in this study.
INTERVENTION: Not applicable.
MAIN OUTCOME MEASURES: The primary outcome was to identify fallers and non-fallers among outpatients with OA based on their history of falls within the past year. We investigated factors including sex, age, body mass index, Kellgren-Lawrence grade, affected side (bilateral or unilateral knee OA), number of comorbidities, pharmacotherapy, physical therapy, pain, and activity as individual predictors of falls. Participants performed one-leg standing test, and five times sit-to-stand test to determine motor function. Sensitivity, specificity, likelihood ratio, and post-test probability of the KOAF screening tool were calculated using receiver operating characteristic (ROC) curve analysis.
RESULTS: The results of one-leg standing test and five times sit-to-stand test differed significantly between the two groups (p < 0.05). ROC curve analysis showed that the area under the curve was 0.88 (95% confidence interval 0.80-0.96, p < 0.001). The post-test probability of falls was 83.3% (positive likelihood ratio, 11.54) when the total score of KOAF screening tool was 2 points and 2.6% (negative likelihood ratio, 0.06) when the total score of KOAF screening tool was <1 point.
CONCLUSIONS: Cross-validation results for the KOAF screening tool were better, confirming that the screening tool could distinguish between fallers and non-fallers with high accuracy. Our findings suggest that this simple screening tool could be readily used in clinical practice and could aid in clinical decision-making through providing choices for physical therapy evaluation and recommendations for physical therapy programs.
Language: en |