From Perception to Performance: A Comprehensive Evaluation in Knee Osteoarthritis.

Understanding Function in Knee Osteoarthritis: Subjective and Objective Perspectives

Knee Osteoarthritis (KOA) is commonly characterized by joint pain, swelling, stiffness, and a reduction in range of motion. These symptoms significantly affect daily activities and overall quality of life. A decrease in physical activity levels may further contribute to the deterioration of joint function over time. Physiotherapy assessment plays a critical role in the management of KOA. Such assessment enables a comprehensive evaluation of parameters including pain intensity, joint range of motion, muscle strength, flexibility, functional status, and quality of life. The use of both subjective and objective assessment methods is essential for developing individualized and effective treatment plans.

Osteoarthritis-specific outcome measures such as the KOOS, WOMAC, and the Lequesne Algofunctional Osteoarthritis Index include subscales that question pain and physical function, thereby enabling the subjective assessment of pain. Among these instruments, the KOOS specifically allows the evaluation of sports and recreational activities as well as quality of life, WOMAC provides assessment of joint stiffness, and the Lequesne Algofunctional Osteoarthritis Index evaluates walking distance. Objectively, algometric measurements enable the determination of pain sensitivity. In addition, muscle strength can be assessed using a hand dynamometer and isokinetic devices; joint proprioception can be evaluated with inclinometers and isokinetic systems; and flexibility can be measured through standardized flexibility tests. Among objective functional test methods, the 30-second sit-to-stand test provides information regarding lower extremity strength, whereas the Timed Up and Go test is another objective tool used to assess lower extremity function and balance. For the objective evaluation of walking capacity, tests such as the 2-minute walk test, 6-minute walk test, and 20- and 40-meter walk tests may be employed. Within the scope of our study, knee joint function will be evaluated using the subjective measures WOMAC, the Lequesne Algofunctional Knee Index, and the Lysholm Knee Score, as well as the objective measures including the 2-minute walk test, the 30-second sit-to-stand test, and the 9-step stair test.

Inclusion Criteria:

• Diagnosis of knee osteoarthritis at Kellgren-Lawrence Grade 2-3,
• Age between 45 and 75 years,
• A history of chronic knee pain lasting at least 6 months,
• Absence of other diagnosed pathologies that could cause knee joint pain,
• Willingness to participate in the study.

Exclusion Criteria:

• Body mass index greater than 35 kg/m²,
• A Lysholm Knee Score above 84,
• A history of physiotherapy treatment or intra-articular injection within the previous 6 months,
• A history of knee joint surgery,
• The presence of a cardiorespiratory condition that would prevent the performance of functional tests,
• The presence of a neuropsychiatric disorder that would interfere with the ability to follow instructions.