The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a widely used, proprietary set of standardized
questionnaire
A questionnaire is a research instrument that consists of a set of questions (or other types of prompts) for the purpose of gathering information from respondents through survey or statistical study. A research questionnaire is typically a mix of ...
s used by health professionals to evaluate the condition of patients with
osteoarthritis
Osteoarthritis (OA) is a type of degenerative joint disease that results from breakdown of joint cartilage and underlying bone which affects 1 in 7 adults in the United States. It is believed to be the fourth leading cause of disability in the w ...
of the
knee and
hip, including pain, stiffness, and physical functioning of the joints. The WOMAC has also been used to assess back pain,
rheumatoid arthritis
Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and hands are invol ...
,
juvenile rheumatoid arthritis
Juvenile may refer to:
*Juvenile status, or minor (law), prior to adulthood
*Juvenile (organism)
* Juvenile (rapper) (born 1975), American rapper
* ''Juvenile'' (2000 film), Japanese film
* ''Juvenile'' (2017 film)
*Juvenile (greyhounds), a greyh ...
,
systemic lupus erythematosus, and
fibromyalgia. It can be self-administered and was developed at
Western Ontario and
McMaster Universities in 1982.
Higher scores indicate worse pain, stiffness, and functional limitations. The WOMAC measures five items for
pain (score range 0–20), two for stiffness (score range 0–8), and 17 for functional limitation (score range 0–68).
Physical functioning questions cover everyday activities such as stair use, standing up from a sitting or lying position, standing, bending, walking, getting in and out of a car, shopping, putting on or taking off socks, lying in bed, getting in or out of a bath, sitting, and heavy and light household duties.
The questions on the WOMAC are a subset of the questions of the Hip disability and osteoarthritis outcome score (HOOS).
Thus, a HOOS survey may also be used to determine a WOMAC score.
A WOMAC test takes about 12 minutes, but is also available in a short form, (although this has not been as extensively tested as the full version). Versions of the WOMAC have also been developed that can be used in telephone or online surveys.
It has been translated into more than 65 languages.
The
American College of Rheumatology The American College of Rheumatology (ACR; until 1985 called American Rheumatism Association) is an organization of and for physicians, health professionals, and scientists that advances rheumatology through programs of education, research, advocacy ...
notes that the test-retest reliability of the WOMAC varies for the pain, stiffness, and function subscales. The ACR says the pain subscale "has been variable across studies but generally meets the minimum standard." Reliability for the physical function scale "has been more consistent and stronger... but the stiffness subscale has shown low test-retest reliability."
When used in clinical studies, the WOMAC pain and function subscales perform comparably or better than other tests in being responsive to change from experimental interventions, but this varies for the different subscales and types of intervention.
An example of an arthritis study using the WOMAC
found a significant
exposure–response relationship between body weight loss (or gain) and clinically significant improvements (or declines) in WOMAC function and pain for people with osteoarthritis of the knee.
See also
*
Kellgren-Lawrence grading scale
References
Arthritis
Musculoskeletal radiographic signs
Medical scoring system
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