Performing region-specific tasks does not improve lower extremity patient-reported outcome scores

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Health Outcomes Research

Background:

• Patient-reported outcome measures (PROMs) assess patient perspectives on health status using validated instruments.
• The QuickDASH (Quick Disability of Arm, Shoulder and Hand) for upper extremity issues shows score improvements after task completion.
• This suggests PROMs scores might be modifiable by performing instrument-related tasks.

Purpose of the Study:

• To investigate if performing tasks associated with lower extremity PROMs (HOOS-JR and KOOS-JR) improves patient scores.
• To compare the modifiability of lower extremity PROMs with previously observed upper extremity PROM changes.

Main Methods:

• 47 hip and 62 knee osteoarthritis patients were randomized into intervention and control groups.
• Patients completed the Hip Disability and Osteoarthritis Outcome Score for Joint Reconstruction (HOOS-JR) or Knee Injury and Osteoarthritis Outcome Score for Joint Reconstruction (KOOS-JR) instruments.
• Intervention groups performed instrument-specific tasks, while control groups completed the QuickDASH; instruments were repeated post-task.

Main Results:

• No significant differences were found in HOOS-JR or KOOS-JR scores (total or individual) after task completion compared to baseline.
• There were no significant differences in score changes between the intervention and control groups for either lower extremity instrument.

Conclusions:

• Lower extremity disability, as measured by HOOS-JR and KOOS-JR, appears less modifiable through task performance than upper extremity disability.
• Potential reasons include easier contralateral limb compensation for upper extremity deficits and higher frequency of lower extremity activities.
• Further research is needed to understand factors influencing PROMs before widespread use in quality control and reimbursement.