Construct validity and reliability of the Finnish version of the Knee Injury and Osteoarthritis Outcome Score

Abstract Background The Knee Injury and Osteoarthritis Outcome Score (KOOS) is a commonly used knee assessment and outcome tool in both clinical work and research. However, it has not been formally translated and validated in Finnish. The purpose of this study was to translate and culturally adapt the KOOS questionnaire into Finnish and to determine its validity and reliability among Finnish middle-aged patients with knee injuries. Methods KOOS was translated and culturally adapted from English into Finnish. Subsequently, 59 patients with knee injuries completed the Finnish version of KOOS, Western Ontario and McMaster Osteoarthritis Index (WOMAC), Short-Form 36 Health Survey (SF-36) and Numeric Pain Rating Scale (Pain-NRS). The same KOOS questionnaire was re-administered 2 weeks later. Psychometric assessment of the Finnish KOOS was performed by testing its construct validity and reliability by using internal consistency, test-retest reliability and measurement error. The floor and ceiling effects were also examined. Results The cross-cultural adaptation revealed only minor cultural differences and was well received by the patients. For construct validity, high to moderate Spearman’s Correlation Coefficients were found between the KOOS subscales and the WOMAC, SF-36, and Pain-NRS subscales. The Cronbach’s alpha was from 0.79 to 0.96 for all subscales indicating acceptable internal consistency. The test-retest reliability was good to excellent, with Intraclass Correlation Coefficients ranging from 0.73 to 0.86 for all KOOS subscales. The minimal detectable change ranged from 17 to 34 on an individual level and from 2 to 4 on a group level. No floor or ceiling effects were observed. Conclusion This study yielded an appropriately translated and culturally adapted Finnish version of KOOS which demonstrated good validity and reliability. Our data indicate that the Finnish version of KOOS is suitable for assessment of the knee status of Finnish patients with different knee complaints. Further studies are needed to evaluate the predictive ability of KOOS in the Finnish population

Associations between self-rated depressive symptoms and quality of life in Finnish males aged 30 to 40

Peer reviewe

Relationships of leisure-time physical activity and work ability between different occupational physical demands in adult working men

Purpose Leisure-time physical activity (LTPA) is known to be associated with positive health benefits, but the role of occupational physical demands remains inconsistent. The purpose of the current study was to assess the relationship between LTPA and work ability in different occupational physical activity (OPA) levels between young adult men. Methods We performed physical activity measurements in work and leisure time with the long version of International Physical Activity Questionnaire (IPAQ) and work ability with the Work Ability Index (WAI) in 921 Finnish employed male volunteer participants. The participants were divided into LTPA tertiles I ( 28 MET-h/week) and OPA tertiles I (0 MET-h/week), II (= 64 MET-h/week). Results There was a significant relationship between LTPA and WAI in OPA tertiles (adjusted for age, alcohol consumption, working class status, BMI, and employment years). Moreover, each LTPA tertile showed significant linear associations with WAI (P <0.001). Conclusion LTPA is positively associated with work ability among young adult men. More specifically, the relationships between LTPA and WAI were significantly greater in physically demanding jobs than in more passive jobs. Our results indicate the importance of LTPA, particularly with individuals under higher work-related physical strain.Peer reviewe

Assessment of Cartilage Repair Quality With the International Cartilage Repair Society Score and the Oswestry Arthroscopy Score

The International Cartilage Repair Society (ICRS) score and the Oswestry Arthroscopic Score (OAS) have been validated to evaluate repair tissue quality. However, the performance of these scores has not been studied in typical patients undergoing cartilage repair and who have lesions of varying sizes. In this study, we compared the performance of the ICRS and the OAS scores and analyzed the effect of lesion characteristics on the performance of these two scores. Cartilage repair quality was assessed in a total of 104 arthroscopic observations of cartilage repair sites of the knee in 62 patients after autologous chondrocyte implantation. Two observers scored the repair areas independently with the ICRS and the OAS scores. The performance of both scores was evaluated according to internal consistency and inter-rater reliability and correlation between the scores. The frequency and proportion of disagreements were analyzed according to the repair site area and the given score. The correlation between the scores was good (r = 0.91, 95% confidence interval [CI]: 0.87-0.94). Both scores showed moderate internal consistency and inter-rater reliability. Cronbach's alpha was 0.88 (95% CI: 0.80-0.92) for the ICRS score and 0.79 (95% CI: 0.70-0.86) for the OAS score. The intraclass correlation coefficient was 0.89 (95% CI: 0.84-0.92) for the ICRS and 0.81 (95% CI: 0.74-0.87) for the OAS scores. The frequency and proportion of disagreements were higher in larger repair sites. In arthroscopic use, both ICRS and OAS scores perform similarly, however, their reliability deteriorates as the lesion size increases. (c) 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop ResPeer reviewe

Prevalence of and Risk Factors for Back Pain Among Young Male Conscripts During Compulsory Finnish Military Service

Introduction Back pain is a major reason for sick leaves and disability pension in primary health care. The prevalence of back pain among adolescents and young adults is believed to be increasing, and back pain during military service predicts unspecified back pain during later life. The aim of this study was to investigate the prevalence and risk factors of back pain among conscripts in compulsory Finnish military service during the period 1987-2005. Materials and Methods The Finnish Defence Forces recruit all men aged 18 years for compulsory military service, and new conscripts enter the service twice a year. Before entering the service, all conscripts must pass a medical examination and conscripts entering the service are generally healthy. Health care in Finnish military service is organized by the public Garrison Health Center, and all medical records are stored as part of the Finnish health care operation plan. For this study, we randomly selected 5,000 men from the Finnish Population Register Centre, according to their year of birth from five different age categories (1969, 1974, 1979, 1984, and 1989). Results We gathered 4,029 documents for the analysis. The incidence of back pain varied between 18% and 21% and remained unchanged during the examination period. The risk factors for back pain were smoking (risk ratio 1.35, P-valuePeer reviewe

Incidence and risk factors of exercise-related knee disorders in young adult men

Background: Musculoskeletal disorders and injuries are common causes of morbidity and loss of active, physically demanding training days in military populations. We evaluated the incidence, diagnosis, and risk factors of knee disorders and injuries in male Finnish military conscripts. Methods: The study population comprised 5 cohorts of 1000 men performing their military service, classified according to birth year (1969, 1974, 1979, 1984, and 1989). Follow-up time for each conscript was the individual conscript's full, completed military service period. Data for each man were collected from a standard pre-information questionnaire used by defense force healthcare officials and from all original medical reports of the garrison healthcare centers. Background variables for risk factor analysis included the conscripts' service data, i.e., service class (A, B), length of military service, age, height, weight, body mass index (BMI), underweight, overweight, obesity, smoking habit, education, diseases, injuries, and subjective symptoms. Results: Of the 4029 conscripts, 853 visited healthcare professionals for knee symptoms during their military service, and 103 of these had suffered a knee injury. Independent risk factors for the incidence of knee symptoms were: older age; service class A; overweight (BMI 25.0-29.9 kg/m(2)); smoking habit; comprehensive school education only; and self-reported previous symptoms of the musculoskeletal, respiratory, and gastrointestinal system. The majority of visits to garrison healthcare services due to knee symptoms occurred during the first few months of military service. Knee symptoms were negatively correlated with self-reported mental and behavioral disorders. Conclusions: The present study highlights the frequency of knee disorders and injuries in young men during physically demanding military training. One-fifth of the male conscripts visited defense force healthcare professionals due to knee symptoms during their service period. Independent risk factors for the incidence of knee symptoms during military service were age at military service; military service class A; overweight; smoking habit; comprehensive school education only; and self-reported previous symptoms of the musculoskeletal system, respiratory system, or gastrointestinal system. These risk factors should be considered when planning and implementing procedures to reduce knee disorders and injuries during compulsory military service.Peer reviewe

Regular physical exercise before entering military service may protect young adult men from fatigue fractures

BackgroundBone stress fractures are overuse injuries commonly encountered in sports and military medicine. Some fatigue fractures lead to morbidity and loss of active, physically-demanding training days. We evaluated the incidence, anatomical location, risk factors, and preventive measures for fatigue fractures in young Finnish male conscripts.MethodsFive cohorts of 1000 men performing military service, classified according to birth year (1969, 1974, 1979, 1984, 1989), were analysed. Each conscript was followed for his full military service period (180days for conscripts with rank and file duties, 270days for those with special training, 362days for officers and highly trained conscripts). Data, including physical activity level, were collected from a standard pre-information questionnaire and from the garrisons' healthcare centre medical reports. Risk factor analysis included the conscripts' service class (A, B), length of military service, age, height, weight, body mass index, smoking, education, previous diseases, injuries, and subjective symptoms, as well as self-reports of physical activity before entering the service using a standard military questionnaire.ResultsFatigue fractures occurred in 44 (1.1%) of 4029 men, with an incidence of 1.27 (95% confidence interval: 0.92-1.70) per 1000 follow-up months, and mostly (33/44, 75%) occurred at the tibial shaft or metatarsals. Three patients experienced two simultaneous stress fractures in different bones. Most fatigue fractures occurred in the first 3months of military service. Conscripts with fatigue fractures lost a total of 1359 (range 10-77) active military training days due to exemptions from duty. Conscripts reporting regular (>2 times/week) physical activity before entering the military had significantly fewer (p=0.017) fatigue fractures. Regular physical activity before entering the service was the only strong explanatory, protective factor in the model [IRR=0.41 (95% CI: 0.20 to 0.85)]. The other measured parameters did not contribute significantly to the incidence of stress fractures.ConclusionRegular and recurrent high-intensity physical activity before entering military service seems to be an important preventive measure against developing fatigue fractures. Fatigue fractures should be considered in conscripts seeking medical advice for complaints of musculoskeletal pain, and taken into consideration in planning military and other physical training programs.Peer reviewe

Polven rustovaurioiden korjausmenetelmät

•Al­le 40-vuo­tiai­den vam­ma­pe­räi­siä oi­rei­le­via rus­to­vau­rioi­ta voi­daan hoi­taa useil­la me­ne­tel­mil­lä. •Pie­niin vau­rioi­hin so­pi­via me­ne­tel­miä ovat mik­ro­mur­tu­ma­me­ne­tel­mä ja luu-rus­to­sy­lin­te­ri­siir­re. •Rus­to­so­lu­siir­re­hoi­to­jen hin­ta on nous­sut kor­keak­si, ei­vät­kä hoi­don edut mui­hin hoi­to­muo­toi­hin näh­den ole osoit­tau­tu­neet ko­vin suu­rik­si, jo­ten käyt­tö tu­li­si ra­joit­taa eri­tyis­ta­pauk­siin ja yk­sik­köi­hin, jois­sa me­ne­tel­mäs­tä on ko­ke­mus­ta. •Uu­te­na hoi­to­muo­to­na vai­kei­den rus­to­puu­tos­ten hoi­dos­sa voi­daan käyt­tää elin­luo­vut­ta­jil­ta saa­ta­via ­luu-rus­to­tuo­re­ku­dos­siir­tei­tä. •Uu­sien bio­ma­te­riaa­lei­hin tai me­sen­kyy­mi­kan­ta­so­lui­hin pe­rus­tu­vien hoi­to­muo­to­jen ke­hi­tys­työ on vil­kas­ta, mut­ta me­ne­tel­mät ovat edel­leen pääa­sias­sa ko­keel­li­sia. •Oi­reet­to­mia rus­to­vau­rioi­ta ei pi­dä hoi­taa ki­rur­gi­ses­ti, ei­kä rus­to­vau­rioi­den ki­rur­gi­ses­ta hoi­dos­ta ­ny­ky­me­ne­tel­min ole hyö­tyä ni­vel­ri­kon hoi­dos­sa.Peer reviewe

Construct validity and reliability of the Finnish version of the Knee Injury and Osteoarthritis Outcome Score

Background: The Knee Injury and Osteoarthritis Outcome Score (KOOS) is a commonly used knee assessment and outcome tool in both clinical work and research. However, it has not been formally translated and validated in Finnish. The purpose of this study was to translate and culturally adapt the KOOS questionnaire into Finnish and to determine its validity and reliability among Finnish middle-aged patients with knee injuries. Methods: KOOS was translated and culturally adapted from English into Finnish. Subsequently, 59 patients with knee injuries completed the Finnish version of KOOS, Western Ontario and McMaster Osteoarthritis Index (WOMAC), Short-Form 36 Health Survey (SF-36) and Numeric Pain Rating Scale (Pain-NRS). The same KOOS questionnaire was re-administered 2 weeks later. Psychometric assessment of the Finnish KOOS was performed by testing its construct validity and reliability by using internal consistency, test-retest reliability and measurement error. The floor and ceiling effects were also examined. Results: The cross-cultural adaptation revealed only minor cultural differences and was well received by the patients. For construct validity, high to moderate Spearman's Correlation Coefficients were found between the KOOS subscales and the WOMAC, SF-36, and Pain-NRS subscales. The Cronbach's alpha was from 0.79 to 0.96 for all subscales indicating acceptable internal consistency. The test-retest reliability was good to excellent, with Intraclass Correlation Coefficients ranging from 0.73 to 0.86 for all KOOS subscales. The minimal detectable change ranged from 17 to 34 on an individual level and from 2 to 4 on a group level. No floor or ceiling effects were observed. Conclusion: This study yielded an appropriately translated and culturally adapted Finnish version of KOOS which demonstrated good validity and reliability. Our data indicate that the Finnish version of KOOS is suitable for assessment of the knee status of Finnish patients with different knee complaints. Further studies are needed to evaluate the predictive ability of KOOS in the Finnish population.Peer reviewe

Electromechanical film sensor device for dynamic force recordings from canine limbs

An equipment based on the electromechanical film (EMF) sensors was designed for the measurementof forces acting upon canine limbs. EMF forms an elastic electret, which generates on its surface an electric charge proportional to the the force applied on it. The EMF sensors were calibrated using a conventional material testing device with cyclic loads. The beagles were trained on a treadmill working at horizontal position or with either 15° uphill or downhill inclination. The treadmill belt speed varied from 2.5 km/h to 7.5 km/h. The force under the canine paws varied depending on the inclination of the treadmill. When the dogs ran uphill, weight-bearing on hind1imbs increased 11% but the weight-bearing 0n forelimbs did not change. Downhill running increased weight-bearing on forelimbs by 8% and decreased weight-bcaring of the hindlimbs by 5%. Immobilization of the right hind] imb increased weightbearing on both forelimbs by 7-25% and on the left hindlimb by 56%. One month after a 30° valgus osteotomy operation at the right tibia, the dynamic force recorded From the operated hindlimb was 69% of the control value. Three months after osteotomy, the weight-bearing of the operated limb approachednormal situation. Our results suggest that the EMF sensor is a reliable method for the measurement of dynamic forces acting on the weight-bearing limbs of the dogs