Validity and reliability of the Persian versions of WOMAC Osteoarthritis Index and Lequesne Algofunctional Index

Abstract

The WOMAC Osteoarthritis Index and Lequesne Algofunctional Index have not been translated and validated for Iranian patients with osteoarthritis (OA) of the knee or hip. The aim of this study was to validate the Persian form of WOMAC OA Index and Lequesne Algofunctional Index and to assess their test-retest reliability and convergent validity. Forward/backward translations and consensus panels were conducted to obtain the Persian versions of WOMAC OA Index and Lequesne Algofunctional Index. A non-probability sample of 116 patients with knee/hip osteoarthritis was asked to complete the WOMAC OA Index and Lequesne Algofunctional Index as well as Medical Outcomes Study-20-Item Short Form (SF-20) questionnaires, a visual analogue scales (VAS) of pain and demographic information form. Internal consistency (using Cronbach's alpha) and convergent validity (by examining the Pearson's correlation coefficients) were evaluated to determine the psychometric properties of the questionnaires. In order to evaluate test-retest reliability, 20 randomly selected patients completed the questionnaires, on a second occasion, 7-10 days later. Cronbach's alpha coefficients and intraclass correlation coefficients for the WOMAC OA Index and Algofunctional Index subscales ranged from 0.63 to 0.94 and from 0.53 to 0.96, respectively. Statistically significant correlations were found between WOMAC OA Index, Algofunctional Index and SF-20 subscales and VAS for pain. The Persian version of WOMAC demonstrated a more acceptable validity, internal consistency and reliability compared with the Lequesne Algofunctional Index. However, both indices are valid and reliable instruments for evaluating the OA severity of knee/hip in Iran.

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).…”

“…(11), a significant positive correlation only existed between age and the Lequesne distance subscale, indicating that the correlations of age with the other subscales were not significant. Education showed significant negative correlations with all of the Lequesne subscales in our study and in the study by Nadrian et al (17). 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.…”

“…Education showed significant negative correlations with all of the Lequesne subscales in our study and in the study by Nadrian et al (17). 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 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.…”

“…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.…”