Testing of a Newly Developed Computerized Animated Activity Questionnaire for Assessing Activity Limitations in Patients with Hip and Knee Osteoarthritis

Wilfred FH Peter¹, Mick Loos², Henrica de Vet³, Maarten Boers³, Jaap Harlaar⁴, Leo D. Roorda⁵, Rudolf Poolman⁶, Vanessa Scholtes⁶, Jan Bogaard⁷, Hilda Buitelaar¹, Martijn P.M. Steultjens⁸, Ewa M. Roos⁹, Anne-Christine Rat¹⁰, Francis Guillemin¹¹, Maria Grazia Benedetti¹², Antonio Escobar Martinez¹³, Nina Østerås¹⁴ and Caroline Terwee³, ¹Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands, ²Epidemiology and Biostatistics and the EMGO Institute for Health and Care research, VU University Medical Center, Amsterdam, Netherlands, ³Dep of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands, ⁴Dep of Rehabilitation Medicine and MOVE research institute, VU University Medical Center, Amsterdam, Netherlands, ⁵Amsterdam Rehabilitation Research Center | Reade, Amsterdam, the Netherlands, Amsterdam, Netherlands, ⁶Department of Orthopedics, Joint Research, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands, ⁷Dep of Epidemiology and Biostatistics and the EMGO Institute for Health and Care research, VU University Medical Center, Amsterdam, Netherlands, ⁸Institute for Applied Health Research and School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, ⁹Inst Sports and Biomechanics, University of Southern Denmark, Odense, Denmark, ¹⁰University Paris Descartes, EA 4360 APEMAC, University of Lorraine, Nancy, France, ¹¹INSERM, Centre d'Investigation Clinique - Epidémiologie Clinique (CIC-EC) CIE6, Nancy, France, ¹²Physical Medicine and Rehabilitation Unit, Istituto Ortopedico Rizzoli, Bologna, Italy, ¹³Health Service Research Network on Chronic Diseases (REDISSEC), Basurto University Hospital, Bilbao, Spain, ¹⁴Department of rheumatology, National Advisory Unit for rehabilitation in rheumatology, Diakonhjemmet Hospital, Oslo, Norway

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: activities of daily living (ADL), Hip, Knee, osteoarthritis and outcome measures

Session Information

Title: Innovations in Rheumatologic Care

Session Type: Abstract Submissions (ARHP)

Background/Purpose

Self-report questionnaires and performance-based tests correlate moderately in measuring activity limitations, indicating that they measure different aspects. Self-reports measure mainly how patients think they perform an activity, and is influenced by pain, fatigue or situations they are referring to. This may lead to cross-cultural differences. Performance-based tests measure an artificial situation, is resource-intensive and burdensome for patients. To overcome these drawbacks we developed and tested a pilot version of an Animated Activity Questionnaire (AAQ), which demonstrated some promising features[1]. The aim of this study was to develop a computerized Animated Activity Questionnaire (AAQ) to assess activity limitations in patients with hip/ knee osteoarthritis and preliminary testing of its validity and reliability.

Methods

Based on the pilot version, International Classifications of Functioning core set for osteoarthritis, focus groups of patients, and existing measurement instruments, the AAQ was developed. In 482 patients correlations were calculated between the Animated Activity Questionnaire (AAQ) and self-reported Hip disability and Knee injury Osteoarthritis Outcome physical functioning score. In addition internal consistency was calculated. In 65/482 patients also correlations with performance based tests ( Stair Climbing Test , Timed Up and Go test, and the 30 second Chair Stand Test) were calculated. Test-retest reliability was assessed by repeated scoring in 56/482 patients.

Results

The Animated Activity Questionnaire (AAQ) includes animated videos of 17 basic daily activities with four levels of increasing difficulty (check the following link for two examples: http://kmin-vumc.nl/_14_0.html). Patients were asked to select the video that best matched their own performance. Cronbach’s alpha was 0.95. Correlation with self-reported physical functioning scores was high (0.72). The AAQ correlated moderately with the performance based tests (0.49, 0.44, and 0.57, respectively). Correlations of the AAQ score with pain was lower (0.51) than the correlation of the self-reported physical functioning score with pain (0.75). For test-retest reliability, a Intraclass Correlation Coefficient of 0.97 (95% Confidence Interval 0.93-0.98) was found.

Conclusion A computerized Animated Activity Questionnaire (AAQ) was developed showing a high internal consistency and excellent test-retest reliability. Content validity was considered good, and construct validity is supported by high correlations with self-reported physical functioning and moderate correlations with performance-based tests. The AAQ seems to be less influenced by pain compared with self-reported physical functioning. Since the AAQ needs no reading ability or translation, it has potential for international use. Continuing research will focus on construct validity and cross-cultural validity.

Reference Terwee CB et al. Development and Validation of the Computer-Administered Animated Activity Questionnaire to Measure Physical Functioning of Patients With Hip or Knee Osteoarthritis. Phys Ther. 2014 Feb;94(2):251-61.

Disclosure:

W. F. Peter,
None;

M. Loos,
None;

H. de Vet,
None;

M. Boers,
None;

J. Harlaar,
None;

L. D. Roorda,
None;

R. Poolman,
None;

V. Scholtes,
None;

J. Bogaard,
None;

H. Buitelaar,
None;

M. P. M. Steultjens,
None;

E. M. Roos,
None;

A. C. Rat,
None;

F. Guillemin,
None;

M. G. Benedetti,
None;

A. Escobar Martinez,
None;

N. Østerås,
None;

C. Terwee,
None.

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