Abstract
BackgroundThe Osteoarthritis Research Society International (OARSI) has suggested to asses pain after specific activities consistently in clinical trials on knee OA. The Dynamic weight-bearing Assessment of Pain (DAP) assesses pain during activity (30 s of performing repeated deep knee-bends from a standing position). The purpose of this study is to evaluate the construct validity, responsiveness, and interpretability of the DAP for knee osteoarthritis (OA).MethodsOne-hundred participants with knee OA were tested twice each with the DAP, the Knee injury and Osteoarthritis Outcome Score (KOOS), six-minute-walk-test (6MWT), and 6-min-walk-test with subsequent pain rating (6MWTpain), and once with a transition questionnaire (TRANS-Q) for the patient-reported change in pain after 12 weeks of exercise. Construct validity (baseline-scores) and responsiveness (change-scores) were estimated by Spearman Correlation Coefficients. We hypothesized that no correlations would be excellent (<0.7) (divergent validity), except for the 6MWTpain (convergent validity). The TRANS-Q was used for interpreting the DAP change-scores in terms of responsiveness and Minimal Important Change (MIC).ResultsDivergent validity with the KOOS subscales (r = −0.31 to–0.45) and the 6MWT (r = −0.25) was supported. Convergent validity with the 6MWTpain was not supported (r = 0.54). The DAP change-scores corresponded to patient-reported change in pain (TRANS-Q), while correlations with change-scores on the other instruments were <0.35. The MIC was 2.4 DAP points.ConclusionsThe DAP possesses divergent validity compared to other instruments for knee OA, supporting the potential for this new way of assessing pain directly during activity. Importantly, the DAP change-scores correspond to patient-reported changes in pain, showing responsiveness. A change of 2.4 or more can be interpreted as clinically relevant. The DAP is a promising alternative to using ‘pain on walking’ as a clinical trial inclusion criterion/outcome.
Highlights
The Osteoarthritis Research Society International (OARSI) has suggested to asses pain after specific activities consistently in clinical trials on knee OA
Application of the Dynamic weight-bearing Assessment of Pain (DAP) is in line with The Osteoarthritis Research Society International (OARSI) suggestion for clinical trials on knee OA; "Pain can be assessed after specific activities
Validity Our hypothesis about divergent validity was confirmed with correlations
Summary
The Osteoarthritis Research Society International (OARSI) has suggested to asses pain after specific activities consistently in clinical trials on knee OA. The Dynamic weight-bearing Assessment of Pain (DAP) assesses pain during activity (30 s of performing repeated deep knee-bends from a standing position). The Dynamic weight-bearing Assessment of Pain (DAP) for knee osteoarthritis (OA) is a simple test designed to assess pain during performance of a specified activity in patients with knee OA [1, 2] It is a simple performance test requiring repeated deep knee bends from a standing position for 30 s, with subsequent rating of pain on a 0–10 numeric rating scale (NRS), where 0 indicates ‘no pain’ and 10 ‘worst pain imaginable.’. If a pain assessment occurs after an activity the study team should ensure consistency throughout the trial with the type and duration of activity as well as the timing of the pain assessment after the activity" [4] This consistency is best obtained through a standardized test such as the DAP
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
