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Cited by 331Musculoskeletal pain and rehabilitationOsteoarthritis Treatment and MechanismsTotal Knee Arthroplasty Outcomes

The DOI matches its Crossref record; 68 of the 71 references it cites were found in a registry or an index.

Reliability and validity of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index in Italian patients with osteoarthritis of the knee

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Salaffi, F, Leardini, G, Canesi, B, Mannoni, A, Fioravanti, A, Caporali, R, Lapadula, G, Punzi, L·2003·Osteoarthritis and Cartilage
DOI 10.1016/s1063-4584(03)00089-x
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Abstract

Objective The Western Ontario and McMaster Universities (WOMAC) Osteoarthritis (OA) Index is a tested questionnaire to assess symptoms and physical functional disability in patients with OA of the knee and the hip. We adapted the WOMAC for the Italian language and tested its metric properties in 304 patients with symptomatic OA of the knee.Methods Three hundred and four consecutive patients, attending 29 rheumatologic outpatient clinic in northern, central, and southern Italy, were asked to answer two disease-specific questionnaires (WOMAC and Lequesne algofunctional index) and one generic instrument (Medical Outcomes Study SF-36 Health Survey-MOS SF-36). A sample of 258 patients was readministered the WOMAC 7-10 days after the first visit and the structured interview, which also assessed demographic and other characteristics. Internal consistency was assessed using Cronbach's alpha, reliability using intraclass correlation coefficients (ICCs), and construct and discriminant validity using Spearman's correlations, Wilcoxon rank sum test, and Kruskal-Wallis test.Results All WOMAC subscales (pain, stiffness, and physical function) were internally consistent with Cronbach's coefficient alpha of 0.91, 0.81, and 0.84, respectively. Test-retest reliability was satisfactory with ICCs of 0.86, 0.68, and 0.89, respectively. In comparison with the SF-36, the expected correlations were found when comparing items measuring similar constructs, supporting the concepts of convergent construct validity. Very high correlations were also obtained between WOMAC scores and Lequesne OA algofunctional index. WOMAC physical function, but not WOMAC stiffness and pain subscales, was weakly associated with radiological OA severity (P=0.03). Also, WOMAC pain score was inversely correlated (P=0.01) with years of formal education. Examination of discriminant validity showed that the scores on the WOMAC and SF-36 followed hypothesized patterns: the WOMAC discriminated better among subjects with varying severity of knee problems, whereas the SF-36 discriminated better among subjects with varying levels of self-reported health status and comorbidity.Conclusion The Italian version of WOMAC is a reliable and valid instrument for evaluating the severity of OA of the knee, with metric properties in agreement with the original, widely used version.

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Research works printed but not linked: 3

  1. Leardini, 2001, A multicentric study of annual costs of knee osteoarthritis in Italy, Arthritis Rheum, 44, S313
  2. Lequesne, 1998, Comparison between the WOMAC and the Lequesne indices in patients with knee and hip osteoarthritis, Osteoarthritis Cartilage, 6, 141
  3. Stuki, 1996, Evaluation of a German version of the WOMAC osteoarthritis index, Z Rheumatol, 55, 40

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Metadata

Authors
Salaffi, F., Leardini, G., Canesi, B., Mannoni, A., Fioravanti, A., Caporali, R., Lapadula, G., & Punzi, L.
Affiliations
  • Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT)
  • Azienda Sanitaria di Firenze (IT)
  • University of Siena (IT)
  • University of Pavia (IT)
  • Azienda Universitaria Ospedaliera Consorziale - Policlinico Bari (IT)
  • University of Padua (IT)
Corresponding author
Salaffi, F
ORCID
Venue
Osteoarthritis and Cartilage
Publisher
Elsevier BV
Published
2003-08
Volume
11
Issue
8
Pages
551-560
ISSN
1063-4584 (ISSN-L)
DOI
10.1016/s1063-4584(03)00089-x
OpenAlex
W2087139148
Cited by
331
References
71
Citations by year
2026: 22 · 2025: 33 · 2024: 28 · 2023: 33 · 2022: 25 · 2021: 16 · 2020: 23 · 2019: 13 · 2018: 18 · 2017: 16 · 2016: 10 · 2015: 12 · 2014: 16 · 2013: 6 · 2012: 11
FWCI
3.22
Type
journal article
Language
en
Open access
Licence
Locations
  • Osteoarthritis and Cartilage (publishedVersion)
  • PubMed (publishedVersion)
  • Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
  • IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
  • Università Politecnica delle Marche (Università Politecnica delle Marche) (submittedVersion)
Topics
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
  • Health Sciences › Medicine › Surgery › Total Knee Arthroplasty Outcomes
Keywords
knee osteoarthritis, questionnaire reliability, construct validity, test-retest reliability, SF-36, Lequesne algofunctional index, pain, stiffness, physical function, radiographic severity, educational attainment, health status, comorbidities, patient-reported outcomes, cross-cultural adaptation, Italy, North America
MeSH terms
Aged, Aged, 80 and over, Cross-Sectional Studies, Disability Evaluation, Female, Humans, Italy, Male, Middle Aged, Pain, Surveys and Questionnaires, Reproducibility of Results, Cohort Studies, Comorbidity, Muscle, Skeletal, Osteoarthritis, Knee

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