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Abstract
BackgroundThe Knee Injury and Osteoarthritis Outcome Score (KOOS) is a commonly used knee assessment and outcome tool in both clinical work and research. However, it has not been formally translated and validated in Finnish. The purpose of this study was to translate and culturally adapt the KOOS questionnaire into Finnish and to determine its validity and reliability among Finnish middle-aged patients with knee injuries.MethodsKOOS was translated and culturally adapted from English into Finnish. Subsequently, 59 patients with knee injuries completed the Finnish version of KOOS, Western Ontario and McMaster Osteoarthritis Index (WOMAC), Short-Form 36 Health Survey (SF-36) and Numeric Pain Rating Scale (Pain-NRS). The same KOOS questionnaire was re-administered 2 weeks later. Psychometric assessment of the Finnish KOOS was performed by testing its construct validity and reliability by using internal consistency, test-retest reliability and measurement error. The floor and ceiling effects were also examined.ResultsThe cross-cultural adaptation revealed only minor cultural differences and was well received by the patients. For construct validity, high to moderate Spearman’s Correlation Coefficients were found between the KOOS subscales and the WOMAC, SF-36, and Pain-NRS subscales. The Cronbach’s alpha was from 0.79 to 0.96 for all subscales indicating acceptable internal consistency. The test-retest reliability was good to excellent, with Intraclass Correlation Coefficients ranging from 0.73 to 0.86 for all KOOS subscales. The minimal detectable change ranged from 17 to 34 on an individual level and from 2 to 4 on a group level. No floor or ceiling effects were observed.ConclusionThis study yielded an appropriately translated and culturally adapted Finnish version of KOOS which demonstrated good validity and reliability. Our data indicate that the Finnish version of KOOS is suitable for assessment of the knee status of Finnish patients with different knee complaints. Further studies are needed to evaluate the predictive ability of KOOS in the Finnish population.
Highlights
The Knee Injury and Osteoarthritis Outcome Score (KOOS) is a commonly used knee assessment and outcome tool in both clinical work and research
Patients A total of 59 patients were included in the validity, internal consistency, test-retest, measurement error and floor/ceiling effects assessments
A few individual items (2%), all from the Pain and Sport and Recreation Function subscales, were missing, and a total score for all the subscales was available for all patients (Table 2)
Summary
The Knee Injury and Osteoarthritis Outcome Score (KOOS) is a commonly used knee assessment and outcome tool in both clinical work and research It has not been formally translated and validated in Finnish. For this reason, the Knee injury and Osteoarthritis Outcome Score (KOOS) was developed in the late 1990s as an extension of the WOMAC index to address problems associated with knee injuries and/or knee OA [12] During their visit to the outpatient clinic, in addition to demographic data, patients were asked for anamnestic information regarding their knee problem, and to describe the intensity of their habitual physical activity (low = 1, moderate = 2, or high = 3–4). The KOOS Users Guide 2012 rule was applied for missing items [21]
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