Clinician-reported outcome measures
| Outcome | Assessment tool | Procedures |
| Height | Stadiometer | Patients are measured for standing height in centimetres using a stadiometer placed against the wall. They are instructed to stand with their backs against the wall, heels together, head in a natural position, legs straight, arms at their sides and shoulders relaxed. They should not wear shoes or heavy clothing that could affect their height measurement. The measurement arm is lowered to rest gently on the patient’s head, and the measurement is rounded off to the nearest decimal. |
| Weight (body mass) | Analogue Scale | A traditional weighing scale assesses patients for weight (body mass in kilograms). The scale is placed on a flat and stable surface, and patients are advised not to wear shoes or heavy clothing that could affect their weight measurement. They are instructed to stand still in the centre of the scale, with their feet evenly positioned and their weight evenly distributed. The weight measurement is then recorded and rounded off to the nearest decimal. |
| Knee joint effusion | Patellar Tap/Ballottement Test26 | Patients are evaluated for knee effusion while lying supine on an examination table. The assessor applies downward strokes from the thigh to the leg with the non-dominant hand and then grasps the upper portion of the knee just above the patella. Using two fingers of the dominant hand, they press the patella against the femur in a posterior direction. Increased patellar waving or a spongy joint sensation indicates a positive test result for knee effusion. The test is then repeated on the opposite knee for comparison. |
| Passive knee flexion and extension range of motion | Hand-held Goniometry (HHG)27 | Passive knee extension and flexion range of motion are measured in patients using a long-arm goniometer. Both knees are measured for comparison with the goniometer axis placed at the lateral epicondyle of the femur. The proximal arm of the goniometer is placed alongside the lateral midline of the femur, using the greater trochanter as a reference. In contrast, the distal arm is placed alongside the lateral midline of the fibula, using the lateral malleolus and fibular head as references. For passive knee flexion, the patient lies supine on the examination table, with the lower limbs in an anatomical position. The assessor flexes the patient’s knee through the available range of motion by sliding the patient’s foot along the table towards the pelvis and then taking the passive range of motion measurement. For passive knee extension, the patient lies in a supine position on the examination table with the lower limbs in an anatomical position and a towel under the ankle with the knee extended as far as possible. The assessor provides added pressure to the knee in the direction of extension and then takes the passive range of motion measurement. |
| Knee extensor and flexor muscle length | HHG27 | The length of the knee flexors and knee extensors muscles in patients is measured using specific tests and a long-arm goniometer. The measurements are taken on both knees for comparison, with the goniometer axis placed at the lateral epicondyle of the femur. For the knee flexors muscle length (Thomas test), the patient lies in a supine position with the hip of the lower extremity to be measured and extended on the examination table. The leg is supported on the table, and the knee is just past the table’s edge (test side). The patient is asked to flex the contralateral hip and grasp the knee to the chest until the lumbar spine is felt to flatten against the table, and the measurement of knee flexion is taken (test side). For the knee flexors muscle length (prone technique), the patient lies in a prone position with both hips of the lower extremity extended on the examination table. The knee to be tested moves to maximal achieved flexion, and the measurement of knee flexion is taken (test side). For the knee extensors muscle length (distal hamstring length test), the patient lies in a supine position with the hip of the lower extremity to be measured in 90 degrees of flexion on the examination table. While the assessor helps maintain the hip position, the patient executes a knee extension, and the knee flexion is measured (test side). |
| Extensor and flexor isometric muscle strength | Hand-held Dynamometry28 | The microFET2 is used to measure the isometric strength of the hamstrings and quadriceps in patients. This measurement is taken on both knees to allow for comparison. The patient is seated on an examination table with their hips and knees flexed at a 90-degree angle. The assessor stabilises the patient’s leg using the leg of the examination table as support for the hand-held dynamometer. The patient is then instructed to apply maximum force against the device. First, the patient is asked to try to extend the knee, and then they are asked to flex the knee. Three repetitions are performed for both extension and flexion. |