Cross-validation of a screening tool to distinguish between fallers and non-fallers in community-dwelling older adults with knee osteoarthritis

Abstract Objective This study aimed to cross-validate a previously developed knee osteoarthritis falls (KOAF) screening tool to distinguish between fallers and non-fallers in community-dwelling older adults with knee osteoarthritis (OA). Design A cross-sectional survey study. Setting Three independent orthopedic clinics. Participants Eighty-six older outpatients with knee OA (71 females, 15 males; mean age, 75.2 ± 6.2 years) participated in this study. Intervention Not applicable. Main outcome measures The primary outcome was to identify fallers and non-fallers among outpatients with OA based on their history of falls within the past year. We investigated factors including sex, age, body mass index, Kellgren-Lawrence grade, affected side (bilateral or unilateral knee OA), number of comorbidities, pharmacotherapy, physical therapy, pain, and activity as individual predictors of falls. Participants performed one-leg standing test, and five times sit-to-stand test to determine motor function. Sensitivity, specificity, likelihood ratio, and post-test probability of the KOAF screening tool were calculated using receiver operating characteristic (ROC) curve analysis. Results The results of one-leg standing test and five times sit-to-stand test differed significantly between the two groups (p Conclusions Cross-validation results for the KOAF screening tool were better, confirming that the screening tool could distinguish between fallers and non-fallers with high accuracy. Our findings suggest that this simple screening tool could be readily used in clinical practice and could aid in clinical decision-making through providing choices for physical therapy evaluation and recommendations for physical therapy programs.