title: The concept of physical limitations in knee osteoarthritis: as viewed by patients and health professionals.
abstract: OBJECTIVE
  To comprehensively identify components of the physical limitation concept in knee osteoarthritis (OA) and to rate the clinical importance of these using perspectives of both patients and health professionals.
  
  
  METHODS
  Concept mapping, a structured group process, was used to identify and organize data in focus groups (patients) and via a global web-based survey (professionals). Ideas were elicited through a nominal group technique and then organized using multidimensional scaling, cluster analysis, participant validation, rating of clinical importance, and thematic analyses to generate a conceptual model of physical limitations in knee OA.
  
  
  RESULTS
  Fifteen Danish patients and 200 international professionals contributed to generating the conceptual model. Five clusters emerged: 'Limitations/physical deficits'; 'Everyday hurdles'; 'You're not the person you used to be'; 'Need to adjust way of living'; and 'External limitations,' each with sub-clusters. Patients generally found their limitations more important than the professionals did.
  
  
  CONCLUSIONS
  Patients and professionals agreed largely on the physical limitation concept in knee OA. Some limitations of high importance to patients were lower rated by the professionals, highlighting the importance of including patients when conceptualizing patient outcomes. These data offer new knowledge to guide selection of clinically relevant outcomes and development of outcome measures in knee OA.
authors: Department of Rheumatology, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000, Frederiksberg, Copenhagen, Denmark. Louise.Klokker.Madsen@regionh.dk.
authors: Louise
authors: http://orcid.org/0000-0003-2463-0990
authors: L
authors: Klokker
authors: Population Health Strategic Research Centre, School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Australia. richard.osborne@deakin.edu.au.
authors: Richard
authors: R
authors: Osborne
authors: Department of Rheumatology, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000, Frederiksberg, Copenhagen, Denmark. eva.elisabet.waehrens@regionh.dk.|The Research Initiative for Activity Studies and Occupational Therapy, Institute of Public Health, University of Southern Denmark, Odense, Denmark. eva.elisabet.waehrens@regionh.dk.
authors: Eva E
authors: EE
authors: Wæhrens
authors: Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. ole@norgaard.dk.
authors: Ole
authors: O
authors: Norgaard
authors: Department of Rheumatology, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000, Frederiksberg, Copenhagen, Denmark. elisabeth.ann.bandak@regionh.dk.
authors: Elisabeth
authors: E
authors: Bandak
authors: Department of Rheumatology, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000, Frederiksberg, Copenhagen, Denmark. henning.bliddal@regionh.dk.
authors: Henning
authors: H
authors: Bliddal
authors: Department of Rheumatology, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000, Frederiksberg, Copenhagen, Denmark. marius.henriksen@regionh.dk.
authors: Marius
authors: M
authors: Henriksen
mesh_terms: D000368:Aged; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D020370:Osteoarthritis, Knee / Q000453:epidemiology / Q000473:pathology*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Concept mapping; Knee OA; Patient perspective; Physical limitations