الفهرس 
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Abstract
Summary and Conclusion
Osteoarthritis ranks fourth after ischaemic heart disease, cerebrovascular disease and total musculoskeletal disease in impact on health-related quality of life (Reginster, 2002). The major outcomes and indicators associated with osteoarthritis are impairments of joint function including an altered range of motion of the joint and joint laxity, pain or discomfort, limitation of activities and reduced participation. However, many of measurements used to assess function in clinical trials suffer from lack of reproducibility (WHO, 2003).
The present study was designed to assess the functional disability in knee osteoarthritis patients using performance-based tests, comprising the summation of the times taken to undertake the activities of walking, stair ascent and descend and transferring to and from a chair forming the ALF score in correlation to clinical and radiological Kellgren & Lawrence grading system.
Forty three patients with a clinical diagnosis of knee osteoarthritis were included in the study.
All patients were subjected to:
(1) Full history taking.
(2) Clinical examination:
• General (weight, height and BMI).
• Local:
1-Deformity; whether genu valgum, genu varus, flexion or extension deformity or genu recurvatum.
2-Swelling; mild, moderate and severe.
3-Tenderness score; the response was recorded and graded to four grades.
4-Range of active and passive movement; using goniometry.
5-Quadriceps muscle strength.
(3) Radiological evaluation; anteroposterior plain x- ray of the knee was done & all radiographs was assessed for OA using Kellgren and Lawrence scale.
(4) Functional assessment; all patients’ functional capacity was assessed by the aggregated locomotor function (ALF) score, formed by summating the mean timed scores (seconds) from three locomotor functions.
The mean age of the patients in the study was 58.0±9.0 (yrs), the mean time of the (ALF) score in the study patients was 43.58 ± 14.58 sec. with a range 23.92 - 80.42 sec.
Clinically, high mean ALF score was found in patients with muscle power grade 3 (51.55±10.15 sec) than those with quadriceps muscle power grade 4 (48.7±113.18 sec) or grade 5 (36.19±7.43 sec). Patients with score 2 tenderness had a higher mean ALF score (49.62 ±12.38 sec) than those with score 1 (35.75 ± 7.97 sec) or score 0 (28.13 ± 1.03 sec). Patients with varus deformity (52.05 ± 13.55 sec) and flexion deformity (56.55 ±8.10 sec) had higher mean ALF score than those without deformities. This denotes that high ALF score is associated with more functional disability.
Radiologically, patients with X - ray grade 4 have ALF mean higher than those with grade 3, 2 or 1. A significant positive correlation was found between ALF score and age (r=0.453**, P=0.002), weight (r=0.888 , P= 0.022), BMI (r=0.755, P=0.039), VAS for pain (r=0.307* , P=.045) stairs climbing (r=0 .924** , P=0.000), transferring (r=0.923** , P=0.000) and 8m-walk (r= .862** , P=.000) time tests.
Conclusion:
The study demonstrates that a simple timed measure of locomotor function can be used as a measure of physical functioning. The individual components of the ALF challenge the locomotor function of patients with knee OA, but are not so demanding that they cannot be completed.
It was significantly lower with high quadriceps muscle power grade, low tenderness score, patients without effusion or deformity and insignificant or absence of radiological findings of OA. It significantly correlated with age, VAS of pain, weight, BMI, obesity (BMI>30.0 kg/(m)2).
The use of the ALF score can be recommended for consideration as a clinical and research outcome measure with knee OA patients.