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Medical Science Monitor Basic Research


eISSN: 1643-3750

Polish Cross-Cultural Adaptation and Validation of the Knee Outcome Survey Activities of Daily Living Scale (KOS-ADLS) in Patients Undergoing Total Knee Arthroplasty

Magdalena Szczepanik, Agnieszka Bejer, Sławomir Snela, Daniel Szymczyk, Jarosław Jabłoński, Joanna Majewska

Institute of Physiotherapy, Medical Faculty, University of Rzeszów, Rzeszów, Poland

Med Sci Monit 2018; 24:5309-5319

DOI: 10.12659/MSM.908094

Available online:

Published: 2018-07-31

BACKGROUND: The Knee Outcome Survey Activities of Daily Living Scale (KOS-ADLS) is a self-reported questionnaire used for the evaluation of the overall health of patients with knee dysfunctions. The purpose of this study was to perform a cross-cultural adaptation of the Polish version of KOS-ADLS and to evaluate its psychometric properties in patients at the end-stage of knee osteoarthritis who were qualified for a total knee replacement (TKR).
MATERIAL AND METHODS: Seventy patients consecutively qualified for surgical TKR procedure participated in this study. To adapt the KOS-ADLS, the following scales and reference tests were used: Knee injury and Osteoarthritis Outcome Score (KOOS), Visual Analogue Scale (VAS), Time Up and Go test (TUG), and Five Times Sit to Stand test (5×STS). The studies were conducted 3 times: 2 weeks before surgery (first study), 6 to 13 days later (retest), and 6 months after surgery.
RESULTS: The Polish version of KOS-ADLS showed excellent reliability (ICC=0.89 SEM=2.68, MDC=7.43) and high responsiveness (ES=4.76, SRM=3.18). The internal consistency was poor in the first assessment (Cronbach’s alpha=0.68), but acceptable in the post-surgery evaluation (Cronbach’s alpha=0.86). There were fair and moderate correlations found between KOS-ADLS and VAS scales in the first examination, TUG, and 5×STS. Stronger correlations were observed between the results obtained in KOS-ADLS and KOOS.
CONCLUSIONS: The Polish version of the KOS-ADLS demonstrated good reliability, validity, and responsiveness for use in patients who have undergone TKR surgery.

Keywords: Arthroplasty, Replacement, Knee, Osteoarthritis, Knee, Validation Studies