Abstract
This study aimed to answer the following two questions. Firstly, which activities do people waiting for a total knee arthroplasty rate as important? Secondly, does their self-rated performance of these activities improve after surgery?
Methods
The Canadian Occupational Performance Measure (COPM) was originally designed for use by occupational therapists in order to assess the level of occupational performance and the change in self-perception of their performance over time. COPM is now widely being used as a tool for outcome measurement in a variety of studies such as before and after total hip replacement. However, no reports have been published regarding the outcome of TKA.
Fifty five participants underwent a semi-structured interview in which they were asked to list the activities which they felt were most problematic because of their knee osteoarthritis. For the five most important activities they were asked to rate their performance on a scale of 1-10 (1 =unable, 10 = perfectly able). Other outcome measures included the WOMAC, the Knee Society Score (KSS) and the SF36.
Result
All outcome measures showed a significant improvement after surgery (all p<0.001). Average COPM score improved from 3.8 before to 6.4 one year after surgery.
The change in the COPM demonstrated a moderate correlation with SF-36 physical component, a fair correlation with all three WOMAC scores and a fair correlation with the KSS function scores.
The five most reported activities were ascending and descending stairs (93%), walking, (89%) gardening (35%), playing golf (24%) and kneeling.(18%). The subjective performance of the first four activities improved significantly. However, participants reported a decrease in kneeling ability.
Conclusion
This study showed that the COPM is responsive and associated with other common outcome measures. On average most activities were rated with higher performance scores but others such as kneeling was not. This information should assist the guidance of patient expectations.
