Tracking a patient’s KOOS scores can help monitor the progress of their knee OA (or other condition). Exploring the sub-scales can offer insight into how it affects their day-to-day life, but how does the patient in front of you compare with the “normal” population?
“The 1000 Norms Project is a ground-breaking research project currently generating great national and international interest. An initiative of leading researchers at The University of Sydney, the aim of the study is to improve our understanding of the physical capabilities of the healthy population across the lifespan.” The researchers have published normative data on various physical and activity parameters including flexibility, strength, plantar pressure, physical outcome measures and also a normative reference data set for KOOS.
The project collected demographic data, PROMs, physical and functional measures on 900 participants (8-101 years). Subjects with health conditions impacting physical function such as known OA, past knee injury, malignant disease, cardiopulmonary or neurological conditions affecting mobility, BMI > 40 etc were excluded from the study. The group represented a spread of socioeconomic areas within the Greater Sydney metropolitan area reflective of the Australian population.

reference data and factors associated with the Knee injury and
Osteoarthritis Outcome Score (KOOS) and KOOS-Child
J.N. Baldwin y *, M.J. McKay y, M. Simic k, C.E. Hiller y, N. Moloney y z, E.J. Nightingale y,
J. Burns y x, On behalf of the 1000 Norms Project Consortium
Variables independently associated with higher pain and disability.
- female gender
- older age
- lower self-efficacy (New General Self-Efficacy Scale)
- worse physical outcome measures (6 min walk, 30 sec chair stand, timed up and down stair tests)
- greater BMI
- varus lower limb alignment
- lower knee flexion range
- lower hip external rotation strength.
KOOS 5 is an average of the scores from the 5 individual sub-scales. The graphs below are the mean sub-scale scores across the age groups for each gender. A higher score reflects better function or less symptoms. Note that the sub-scales of “participation in Sport and Recreation” and “Quality of Life” are most impacted by increasing age.
To be honest, we find this style of graph difficult to interpret at a glance and cumbersome to explain to patients. At myscoreit, we have therefore kept our graphical displays as user friendly as possible. We display a KOOS 5 score as well as a breakdown of the sub-scale scores when you hover over the bars – simple.
To get started using the KOOS outcome measure, and other MSK PROMs, sign up at www.myscoreit.com