Use of Response Shift to Improve Agreement Between Patient Reported Outcomes and Performance-based Testing in Knee Patients

Patient-Reported Outcome Measures (PROMs) have been used alongside disease-oriented measures and performance-based measures to evaluate health outcomes. The frequency with which outcomes measures are being evaluated within orthopaedic and athletic populations has increased; however it has been observed that PROMs, often correlate poorly with performance-based measures. This disaccord between self-report and performance-based measures may be due in part to testing order, particularly if PROMs, which may inquire about activities the patient has not performed recently, are completed prior to performance based testing. This will be a randomized controlled trial to determine if PROM scores are affected by testing order (PROM-then-performance testing vs. performance testing-then-PROM). Additionally the effect of testing order on the correlation between self-report and physical performance measures will be examined. Participants (n =32) will include individuals returning to activity after suffering a knee injury. Participants will complete the International Knee Documentation Committee (IKDC) and the Sports and Recreation Subscale of the Knee Injury Osteoarthritis and Outcome Score (KOOS) prior to and after completing performance-based measures. Performance measures will include single-leg hop for distance, crossover hop, 30s step-down test and the zig-zag. The results of this study may provide a basis for best-practices in outcomes evaluation and return-to-activity assessment.