Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb 1;18(1):145-159.
doi: 10.26603/001c.67938. eCollection 2023.

Confirmatory Factor Analysis of the Hip Disability and Osteoarthritis Outcome Score (HOOS) and Associated Sub-scales

Emilie N Miley  1   2 , Madeline P Casanova  3 , Scott W Cheatham  4 , Lindsay Larkins  4 , Michael A Pickering  5 , Russell T Baker  3
Affiliations

Confirmatory Factor Analysis of the Hip Disability and Osteoarthritis Outcome Score (HOOS) and Associated Sub-scales

Emilie N Miley et al. Int J Sports Phys Ther. .

Abstract

Background: Hip Disability and Osteoarthritis Outcome Score (HOOS), HOOS-Joint Replacement (JR), HOOS Physical Function (PS), and HOOS-12 item scale have been suggested as reliable and valid instruments for assessing hip disability. However, factorial validity, invariance across subgroups, and repeated measures of the scale across different populations have not been well supported in the literature.

Purpose: The primary study objectives were to: (1) assess model fit and psychometric properties of the original 40-item HOOS scale, (2) assess model fit of the HOOS-JR, (3) assess model fit of the HOOS-PS, and (4) assess model fit of the HOOS-12. A secondary objective was to perform multigroup invariance testing across physical activity level and hip pathology subgroups for models that met recommended fit indices.

Study design: Cross-Sectional Study.

Methods: Individual confirmatory factor analyses (CFAs) were conducted for the HOOS, HOOS-JR, HOOS-PS, and HOOS-12. Additionally, multigroup invariance testing (i.e., activity level, injury type) was conducted on the HOOS-JR and HOOS-PS.

Results: Model fit indices did not meet contemporary recommendations for the HOOS and the HOOS-12. Model fit indices for the HOOS-JR and the HOOS-PS met some, but not all, contemporary recommendations. Invariance criteria was met for the HOOS-JR and HOOS-PS.

Conclusion: The scale structure of the HOOS and HOOS-12 were not supported; however, preliminary evidence to support the scale structure of the HOOS-JR and HOOS-PS was found. Clinicians and researchers who utilize the scales should do so with caution due to their limitations and untested properties until further research establishes the full psychometric properties of these scales and recommendations for their continued use.

Keywords: hip disability; hip osteoarthritis; patient outcomes; physically active.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest

Figures

Figure 1.
Figure 1.. The Hip Dysfunction and Osteoarthritis Score (HOOS) scale hierarchical confirmatory factor analysis measurement model with standardized loadings (n = 656).
Figure 2.
Figure 2.. The HOOS-JR scale hierarchical confirmatory factor analysis measurement model with standardized loadings (n = 656).
Figure 3.
Figure 3.. The HOOS-PS hierarchical confirmatory factor analysis measurement model with standardized loadings (n = 656).
Figure 4.
Figure 4.. The HOOS-12 item scale hierarchical confirmatory factor analysis measurement model with standardized loadings (n = 656).
See this image and copyright information in PMC

References

    1. Psychometric properties of the OARSI/OMERACT osteoarthritis pain and functional impairment scales: ICOAP, KOOS-PS and HOOS-PS. Ruyssen-Witrand A, Fernandez-Lopez CJ, Gossec L, Anract P, Courpied JP, Dougados M. 2011Clinical and Experimental Rheumatology-Incl Supplements. 29(2):231.. - PubMed
    1. Changes in outcome measures for impairment, activity limitation, and participation restriction over two years in osteoarthritis of the lower extremities. Botha‐Scheepers Stella, Watt Iain, Rosendaal Frits R., Breedveld Ferdinand C., Hellio le Graverand Marie-Pierre, Kloppenburg Margreet. Dec 15;2008 Arthritis & Rheumatism. 59(12):1750–1755. doi: 10.1002/art.24080. doi: 10.1002/art.24080. - DOI - DOI - PubMed
    1. Outcomes research: shifting the dominant research paradigm in physical therapy. Jette Alan M. Nov 1;1995 Physical Therapy. 75(11):965–970. doi: 10.1093/ptj/75.11.965. doi: 10.1093/ptj/75.11.965. - DOI - DOI - PubMed
    1. The disablement in the physically active scale, part II: The psychometric properties of an outcomes scale for musculoskeletal injuries. Vela Luzita I., Denegar Craig R. Nov 1;2010 Journal of Athletic Training. 45(6):630–641. doi: 10.4085/1062-6050-45.6.630. doi: 10.4085/1062-6050-45.6.630. - DOI - DOI - PMC - PubMed
    1. Osteoarthrosis of the hip in women and its relationship to physical load from sports activities. Vingård Eva, Alfredsson Lars, Malchau Henrik. Jan;1998 The American Journal of Sports Medicine. 26(1):78–82. doi: 10.1177/03635465980260013101. doi: 10.1177/03635465980260013101. - DOI - DOI - PubMed

LinkOut - more resources