Concurrent validity of the 2-and 6-minute walk test in knee osteoarthritis

Psychometric properties of the Mini-Balance Evaluation Systems Test and physical function measures in patients with Ehlers-Danlos syndrome/hypermobility spectrum disorders

PURPOSE

Ehlers-Danlos syndrome (EDS) and hypermobility spectrum disorders (HSD) are associated with impairments in balance and physical function. However, the psychometric properties of relevant outcome measures remain largely unexplored. The objectives of this study were to evaluate the construct validity of the Mini-Balance Evaluation Systems Test (Mini-BESTest) alongside the test-retest reliability of the Mini-BESTest, Six Minute Walk Test (6MWT), and Lower Extremity Functional Scale (LEFS) in patients with the hypermobility subtype of EDS (hEDS) and HSD.

MATERIALS AND METHODS

Participants with hEDS/HSD (n = 20) attended two visits scheduled one to two weeks apart. The construct validity of the Mini-BESTest was determined through Pearson correlations between force plate balance measures, 6MWT, and LEFS. Test-retest reliability of the measures was evaluated through intraclass correlation coefficients (ICC). Minimal detectable change values with 95% confidence (MDC95) were also calculated.

RESULTS

Mini-BESTest demonstrated significant correlations with force plate measures, 6MWT, and LEFS (r = -0.41 to 0.66). Test-retest reliability was excellent for the Mini-BESTest, 6MWT, and LEFS (ICC = 0.91 to 0.96). MDC95 was 4 for the Mini-BESTest, 77 m for the 6MWT, and 11 for the LEFS.

CONCLUSION

The Mini-BESTest is valid and reliable for assessing balance and mobility in patients with hEDS/HSD.IMPLICATIONS FOR REHABILITATIONThe Mini Balance Evaluation Systems Test (Mini-BESTest) is valid in capturing aspects of balance and physical function in patients with hypermobile Ehlers-Danlos syndrome or hypermobility spectrum disorders.However, the Mini-BESTest may show a potential ceiling effect for high functioning patients in this population.The Mini-BESTest, 6 Minute Walk Test, and the Lower Extremity Functional Scale also show excellent test-retest reliability in this population.The Minimal Detectable Change with 95% confidence intervals is 4 for the Mini-BESTest, 77 m for the 6 Minute Walk Test, and 11 for the Lower Extremity Functional Scale in this population.

Movement-evoked pain is not associated with pain at rest or physical function in knee osteoarthritis

INTRODUCTION

Knee Osteoarthritis (KOA) is mainly characterized by pain. The assessment of KOA-related pain frequently focuses on different constructs subject to sources of bias or drawbacks, as the classical Pain at Rest (PAR). Movement-evoked pain (MEP), recently defined as 'pain during walking', emerges as a differential concept, since PAR and MEP are driven by different underlying mechanisms. Given the novelty of the MEP approach, its association with PAR or with different performance-based tests has not been studied in KOA yet.

MATERIALS AND METHODS

A cross sectional study was conducted. PAR was measured, alongside the performance of four mobility tests and their corresponding MEP: Timed Up and Go Test, 10-metre Walk Test, 2-Minute Walk Test, and 6-Minute Walk Test. Association and agreement were explored for MEP versus PAR, while the correlation of the tests versus each corresponding MEP-measure was assessed.

RESULTS

Neither association nor agreement were found in the duality MEP versus PAR. Also, the lack of association between the performance of a mobility test and the perceived level of pain during the development of the test was stated.

CONCLUSION

Movement-evoked pain is neither related to pain at rest nor to functional performance in subjects affected by knee osteoarthritis. The results from our study suggest that MEP and pain at rest measure and refer to different constructs in knee osteoarthritis. The implementation of MEP as an outcome in exercise-therapy could enhance the tracking of results, as well as the development of tailored interventions under different conditions.

SIGNIFICANCE

This research elucidates the relevance of MEP, recently defined as 'pain during walking', through the analysis of its association with PAR and with functional performance (measured through four mobility tests) in knee osteoarthritis. The results from our study highlight the absence of either association or agreement between MEP and PAR, fact that supports and endorses the idea that both concepts measure and refer to different constructs in knee osteoarthritis.

The Effect of Contrast Bath Therapy and Knee Pad Device on Pain, Range of Motion, and Functional Disability in Patients With Osteoarthritis Knee: A Randomized Control Trial

Background and objective A degenerative joint condition mostly affecting the weight-bearing joints is osteoarthritis (OA). The majority of the time, it involves the knee joint. Pain and stiffness are common in grade 1 and 2 OA. And that's the main reason people ask for help. Physiotherapy treatment can be helpful for symptomatic management of early OA. Along with exercises, contrast bath therapy (CBT) is a therapeutic alternative to medication to alleviate pain and stiffness in OA. Many studies have been done using the traditional water immersion CBT. However, there is a paucity of studies on contrast therapy given using a device. This study intends to find the effect of a knee pad device (KPD) on pain, range of motion, and functional disability in knee OA patients when compared with CBT. Methods About 60 patients having unilateral knee OA were selected and randomly divided into two groups: group A received CBT for 20 minutes, and group B was treated with a KPD for 20 minutes and the Otago exercise program was given in both groups for 30 minutes. Both groups received treatment for three sessions per week for two weeks. Outcome measures used for assessment at baseline and post-treatment were visual analog scale (VAS), knee range of motion, Western Ontario and McMaster Universities Arthritis Index (WOMAC) scale, and distance covered in a two-minute walk test. Results Both the groups showed significant improvement post-treatment (p < 0.05). Group B showed more significant improvement when compared with group A. The enhancement in VAS (2.39, p < 0.020), range of motion (2.11, p < 0.039), WOMAC (2.09, p < 0.04), and two-minute walk test (2.03, p < 0.046) showed improvement in functional ability. Conclusion The findings of this study showed that both groups showed improvement following treatment, but that the use of a KPD in combination with strengthening and balance retraining is more efficient in reducing pain and enhancing quality of life in patients with grade 1 or 2 knee OA than conventional CBT.