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This Article Full Text Full Text (PDF) The Bottom Line The Bottom Line Podcast Supplemental Videos All Versions of this Article: ptj.20060066v1 87/9/1106    most recent Submit a response Read responses to this article Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Currier, L. L Articles by Wainner, R. S Search for Related Content PubMed PubMed Citation Articles by Currier, L. L Articles by Wainner, R. S Related Collections Injuries and Conditions: Knee Osteoarthritis Clinical Prediction Rules Osteoarthritis Social Bookmarking                      What's this?

Development of a Clinical Prediction Rule to Identify Patients With Knee Pain and Clinical Evidence of Knee Osteoarthritis Who Demonstrate a Favorable Short-Term Response to Hip Mobilization

LL Currier, PT, DPT, is Staff Physical Therapist, Malcolm Grow Medical Center, Andrews AFB, Md
PJ Froehlich, PT, DPT, is Staff Physical Therapist, Womack Army Medical Center, Fort Bragg, NC
SD Carow, PT, DPT, is Staff Physical Therapist, Guthrie Medical Department, Fort Drum, NY
RK McAndrew, PT, DPT, is Chief of Physical Therapy, Bayne-Jones Army Community Hospital, Fort Polk, LA
AV Cliborne, PT, MPT, was Staff Physical Therapist, Brooke Army Medical Center, Fort Sam Houston Tex, at the time of the study
RE Boyles, PT, DSc OCS, FAAOMPT, serves as faculty, US Army–Baylor Doctoral Program in Physical Therapy, Fort Sam Houston
LT Mansfield, MD, is Director of Musculoskeletal Radiology, Brooke Army Medical Center
RS Wainner, PT, PhD, ECS, OCS, FAAOMPT, is Associate Professor, Texas State University, San Marcos, Tex, and Vice President and Director of Research and Practice, Texas Physical Therapy Specialists, New Braunfels, Tex. Dr Wainner was project advisor while serving as faculty, US Army–Baylor Doctoral Program in Physical Therapy, Fort Sam Houston
Dr Currier, Dr Froehlich, Dr Carow, and Dr McAndrew were students in the US Army–Baylor Doctoral Program in Physical Therapy, Fort Sam Houston, when this research was conducted.

Address all correspondence to Dr Currier at: llcurrier{at}hotmail.com

Background and Purpose: The primary purpose of this study was to develop a clinical prediction rule (CPR) for identifying patients with knee pain and clinical evidence of knee osteoarthritis (OA) with favorable short-term response to hip mobilizations. The secondary purpose was to determine the predictive validity of individual clinical tests for identifying these same patients.

Subjects and Methods: Sixty subjects with knee OA, aged 51 to 79 years, completed self-report questionnaires, a clinical examination of the hip and knee, and functional tests and were treated with 4 hip mobilizations. Follow-up testing was completed 2 days later. The reference criterion for determining a favorable response was either (1) a decrease of at least 30% on composite Numerical Pain Rating Scale score obtained during functional tests or (2) a Global Rating of Change Scale score of at least 3.

Results: The CPR developed in this study comprised 5 variables: (1) hip or groin pain or paresthesia, (2) anterior thigh pain, (3) passive knee flexion less than 122 degrees, (4) passive hip medial (internal) rotation less than 17 degrees, and (5) pain with hip distraction. Based on the pretest probability of success (68%), the presence of one variable had a positive likelihood ratio of 5.1 and increased the probability of a successful response to 92% at 48-hour follow-up. If 2 variables were present, the positive likelihood ratio was 12.9 and the probability of success increased to 97%.

Discussion and Conclusion: The results suggest that the CPR developed in this study could improve clinicians’ decision making and efficiency in examining and treating patients with knee OA.

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