Range of motion as an outcome measure for knee osteoarthritis interventions in clinical trials: an integrated review

Abstract

Background

Osteoarthritis (OA) is a progressive disease causing pain and reduced range of motion (ROM), decreasing function and activity participation. Physiotherapy interventions improve symptoms and quality of life. Goniometry is one method for measuring ROM.

Objective

To conduct an integrative review investigating use of ROM for participants with knee OA following physiotherapy interventions in clinical trials, including reliability, validity and responsiveness of goniometry for measuring knee ROM.

Major Findings

Forty-two articles fulfilled the inclusion criteria. Twenty-six studies used OA patient-reported outcome measures in addition to ROM. Twenty-eight studies reported their own psychometric data, with generally excellent inter- and intra-rater reliability. Nine reported good to excellent criterion validity. Four studies reported limited and variable data on responsiveness.

Conclusions

Knee ROM is commonly used as an outcome measure in clinical trials of people with knee OA. Goniometry is a reliable and valid way to measure knee ROM, and is a convenient, accessible outcome measure for clinical trials and physiotherapy practice. We suggest combining patient-reported outcome measures with goniometry may provide a more holistic view of the person’s wellbeing, function, and participation. Further research is needed to gain a broader understanding of the validity, and responsiveness specifically for people with knee OA.

Keywords:

• Goniometry
• range of motion
• physiotherapy
• parametric properties
• knee osteoarthritis

Acknowledgements

The authors wish to thank Thelma Fisher, Subject Librarian University of Otago for her advice on constructing the search strategy.

Disclosure statement

No potential conflict of interest was reported by the authors.

Biographical note

The first five authors are Bachelor of Physiotherapy students in their final year of the programme. The review was undertaken as part of the requirements for their research paper. Dr Amanda Wilkinson co-supervised the project, provided expertise in review methodology and writing, and learnt a lot about “measurement” in physiotherapy. Dr Cathy Chapple, the primary supervisor, has a research interest in the area of osteoarthritis, and physiotherapy interventions for improving people’s body function and participation. Findings from this review contribute to her ongoing research.