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. The womac index is a diseasespecific, tridimensional self administered questionnaire, for assessing health status and health outcomes in osteoarthritis of the knee andor hip. It is interesting to note that the most reliable component of the womac score was the functional assessment and the total womac score, with a cronbachs alpha greater. Summary of basic reporting of womac pain sub scale and womac index. The transition scale assessed the selfperceived change at the 6week follow up compared to baseline. Koos was developed for younger andor more active patients with knee injury and knee.
Some differential item functioning was observed, but this cancelled out at the test level and, by doing so, at the same time removed the disturbance of unidimensionality. Index womac pain subscale score at screening on a 0100 mm vas scale. Modelling the relationship between the womac osteoarthritis. A flare in oa pain, defined as an increase of at least 15 mm in the womac pain scale from screening to baseline, was required for enrollment. Reliability and validity of the western ontario and mcmaster.
A total womac score can also be produced and is commonly transformed to a 0100 scale for ease of interpretation and comparison with other studies. There is one computerized version of the womac and four basic versions with different types of scales on which the response is scored lk 5 point likert scale, va 10 cm horizontal. The responsiveness was moderate to large, with srm and es ranging from 0. No significant differences measured via vas pain scale. Western ontario and mcmaster universities osteoarthritis. Womac pain subscale change from baseline to weeks 2, 4, 8, 12 and 24. Reporting of the exact method used in administering the womac pain subscale scoring was poor in many cases. Pain 5 items, stiffness 2 items, and physical function 17 items. The scale has three subscales table 1, pain 5 items, stiffness 2 items and physical functioning 17 items. High correlations were observed as expected between the patient nrs and womac function, pain visual analogue scale and patient global assessment. Since its development in 1982, the womac index has undergone several revisions and modifications.
The koos is selfadministered and assesses five outcomes. An extension of the western ontario and mcmaster universities osteoarthritis index. The western ontario and mcmaster universities arthritis index womac is widely used in the evaluation of hip and knee osteoarthritis. There are multiple versions of the aims2, such as the aims2sf. Stiffness is a sensation of restriction or slowness in the ease with which you move your hip joint. If you prefer percentage scores in accordance with the koos, use the formula provided below to convert the original womac scores. The womac takes approximately 12 minutes to complete, and can be taken on paper, over the telephone or. Developed over 20 years ago, womac has been revised multiple times to its most current version, 3. Womac osteoarthritis index rozina and smith physical therapy. Mcmaster osteoarthritis index womac please circle the. P jan 23, 2012 the total womac score at the 6week followup minus the score at baseline examination prior to the treatment defined the effect measured by womac. The western ontario and mcmaster universities osteoarthritis index womac is a widely used, proprietary set of standardized questionnaires used by health professionals to evaluate the condition of patients with osteoarthritis of the knee and hip, including pain, stiffness, and physical functioning of the joints. After the screening visit, patients discontinued use of nsaids or pain medications prior to the baseline visit.
The pain subscale has not been consistent across studies, but it generally. A 40 item questionnaire hip disability and osteoarthritis outcome score, hoos was constructed to assess patientrelevant outcomes in five separate subscales pain, symptoms, activity of daily living, sport and recreation function and hip related quality of life. The questionnaire also includes sections which ask respondents to rate their satisfaction and the impact of arthritis on each of these 12 areas. The western ontario and mcmaster universities osteoarthritis index womac is applied extensively to patients with osteoarthritis of the hip or knee. Total womac pain scale scores can vary from 0 to 500 when va3 scaling is applied and from 0 to 20 when lk3 scaling is implemented. Summary of clinical outcome measures for sportsrelated. Summary of clinical outcome measures for sportsrelated knee.
In a small number of cases the score range specified was not interpretable. Hip disability and osteoarthritis outcome score womac. Visual analogue scale vas instruct the patient to point to the position on the line between the faces to indicate how much pain they are currently feeling. The multidimensional western ontario macmaster osteoarthritis index assesses pain, stiffness, and physical function activities related to oa of the hip or knee. Standing upright none mild moderate severe extreme b. The womac index is a diseasespecific, tridimensional selfadministered questionnaire, for assessing health status and health outcomes in osteoarthritis of the knee andor hip. Western ontario and mcmaster universities osteooarthritis. Womac index was developed for hip and knee osteoarthritis, however it has been used with other rheumatic conditions such as. In 21 of 60 trials, deciding whether a likert scale or vas was used had to be deduced from other information given in the paperusually the score range or the actual baseline or followup data. Please circle the appropriate rating for each item. To get original womac scores, sum the item scores for each subscale. This index has gained growing acceptance in oa assessment since its introduction in 1986.
Additionally, a reduced sevenpoint womac scale has also been validated. Demonstrates hypothesized relationships to other similar measures and to. Pain 0500 pts, stiffness 0200 pts, function 0 1700 pts composite scores can be converted to 0100 scale 0 best recall period. Determinants of womac function, pain and stivness scores. Pdf validation of the shortform womac function scale for the. Validation of the chinese western ontario and mcmaster. Four hundred and seventyfour patients with osteoarthritis of the hip or knee awaiting arthroplasty were administered the womac. Please rate the activities in each category according to the following scale of difficulty.
The western ontario and mcmaster universities osteoarthritis. Jul 26, 2016 authors found that the 5 items of the womac pain scale consist of functionbased behaviors that suggest disability measure attributes versus purely pain, that they are general behaviors rather than those specific to hip or knee oa e. Request further information please complete the following form to request further information. The knee injury and osteoarthritis outcome score koos is an extension of the western ontario and mcmaster universities osteoarthrtis index womac, the most commonly used outcome instrument for assessment of patientrelevant treatment effects in osteoarthritis. Alternatively a visual analogue scale vas may be used ranging from 0 to 10. Authors found that the 5 items of the womac pain scale consist of functionbased behaviors that suggest disability measure attributes versus purely pain, that they are general behaviors rather than those specific to hip or knee oa e. Stiffness the following questions concern the amount of joint stiffness you have experienced during the last week in your hip. The womac westren ontario and mcmaster universities index is used to. The womac captures more than just knee or hip pain and dysfunction, and is clearly influenced by the presence of fatigue, symptom counts, depression and low back. Rasch analysis of the western ontario macmaster questionnaire. Backgroundpurpose the western ontario and mcmaster universities osteoarthritis index womac is a validated and widely used instrument for assessing osteoarthritis oa knee and hip pain, stiffness and physical function. What is the minimum clinically important difference for the. Determinants of womac function, pain and stiffness scores.
Tanezumab for the treatment of pain from osteoarthritis of. Roos em, roos hp, lohmander ls, ekdahl c, beynnon bd. Clinician researchers american college of rheumatology. You will be asked to indicate on this type of scale the amount of pain, stiffness or disability you have experience in the last 48 hours.
Validity and reliability of swedish womac osteoarthritis index. Womac physical function subscale change from baseline to weeks 2, 4, 8, 12 and 24. Knee injury and osteoarthritis outcome score koos koos is developed as an instrument to assess the patients opinion about their knee and associated problems. The womac pain and physical functioning subscales satisfied unidimensionality and ordinal scaling tests, and the ability to transform to an interval scale. The developmental form of the womac had 5 subscales pain, stiffness, physical function, social function, emotional function, the first 3 of which were retained in the original form of the womac and probed the symptom experience of oa in the. Hip disability and osteoarthritis outcome score hoos. Acl anterior cruciate ligament injury, meniscus injury, chondral injury, etc.
The following questions concern the amount of pain you are currently experiencing in your knees. The recall period for specific outcome measures is 48 hours. Request pdf measurement properties of the womac lk 3. In 74% of trials the reporting of the scale used was inadequate.
The current womac survey is comprised of 24 items divided into three subscales. Womac osteoarthritis index yavapai regional medical. Apr 30, 2010 the womac pain and physical functioning subscales satisfied unidimensionality and ordinal scaling tests, and the ability to transform to an interval scale. The womac performed well in ra and fm, and correlated strongly with the health assessment questionnaire haq disability scale and a visual analogue scale vas pain scale.
For each situation, please enter the amount of pain you have experienced in the past 48 hours. The likert version of the womac is rated on an ordinal scale of 0 to 4, with lower scores indicating lower levels of symptoms or physical disability. Think about the stiffness not pain you have in your hipknee during the last 48 hours. These details will be sent to dr bellamy who will respond to your request in due course. Knee injury and osteoarthritis outcome score koos validation and comparison to the womac in total knee replacement. The use and reporting of womac for the assessment of. To determine mcid, the womac effects were related to the transition replies. Womac pain score reflects preceding daily pain ratings in. Summary of basic reporting of womac pain subscale and womac index. The scores for womac pain, stiffness, and physical function subscales, and total score at visit 1 for subjects in the vs population and for healthy volunteers were statistically significantly different i. This study aimed to examine the correlation between womac pain score and reported.
Womac how to score from the koos assign scores from 0 to 4 to the boxes as shown above. Pain 020 pts, stiffness 08 pts, function 068 pts vas scale. Tanezumab for the treatment of pain from osteoarthritis of the knee. There have also been several studies, which have raised issues about the factorial validity of the subscales 5,10. Download pdf, 48kb the auscan index is a diseasespecific, tridimensional selfadministered questionnaire, for assessing health status and health outcomes in. Knee injury and osteoarthritis outcome score koosdevelopment of a selfadministered outcome measure. Patients global assessment of osteoarthritis 5point likert scale change from.
The western ontario and mcmaster universities arthritis index womac is widely used. Altogether 165 patients completed the womac, the visual analogue scale foot and ankle vas fa, the lower extremity functional scale lefs, the 15d healthrelated qualityoflife questionnaire. The answer is most certainly that it is and remains distinctly dynamic. It is a selfadministered questionnaire consisting of 24 items divided into 3 subscales. Koos is intended to be used for knee injury that can result in post traumatic osteoarthritis oa. Scale scores are calculated which range from 0 best score to 10 worst score. The number of different score ranges was high and only 39% of trials used the standard 096, or 02400 or 0240 ranges. Validation of a numerical rating scale to assess functional.
May 30, 2003 a 40 item questionnaire hip disability and osteoarthritis outcome score, hoos was constructed to assess patientrelevant outcomes in five separate subscales pain, symptoms, activity of daily living, sport and recreation function and hip related quality of life. What is the minimum clinically important difference for. The knee injury and osteoarthritis outcome score koos is a questionnaire designed to assess short and longterm patientrelevant outcomes following knee injury. Pain rating scales instructions subjective pain score all patients are to have a functional activity score recorded in addition to the chosen subjective score. The womac is scored on a best to worst scale, so that lower subscale scores represent less pain, less stiffness, or better physical function. Womac pain, stiffness, and function subscales all improved after 12 weeks of supplementation. Womac function, pain or stivness as the dependent in ra and most abnormal in fm, including womac variables, and low back pain, symptom count, vas scores, number of somatic symptoms and the percentage fatigue scale and depression as the independent vari with low back pain. The womac has also been used to assess back pain, rheumatoid.