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European Journal of Physical and Rehabilitation Medicine 2020 Sep 25

DOI: 10.23736/S1973-9087.20.06054-2


language: English

German translation, cross-cultural adaptation and validation of the Musculoskeletal Health Questionnaire: cohort study

Sven KARSTENS 1 , David H. CHRISTIANSEN 2, 3, Melanie BRINKMANN 1, Magali HAHM 1, Gareth MCCRAY 4, Jonathan C. HILL 4, Stefanie JOOS 5

1 Therapeutic Sciences, Department of Computer Science, Trier University of Applied Sciences, Trier, Germany; 2 Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark; 3 Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark; 4 School of Primary, Community and Social Care, Keele University, Staffordshire, UK; 5 Department of General Practice, University of Tuebingen, Tuebingen, Germany


BACKGROUND: The Musculoskeletal Health Questionnaire (MSK-HQ) was developed to measure the health status of patients with various musculoskeletal conditions across multiple settings including rehabilitation.
AIM: Formal translation and cross-cultural adaptation of the MSK-HQ into German (MSK-HQG), to determine test-retest-reliability, standard error of measurement (SEM), smallest detectable change (SDC), construct validity, responsiveness, minimal important change (MIC), and to test for floor or ceiling effects.
DESIGN: Cohort study with six weeks follow-up.
SETTING: Seven physiotherapy clinics/rehabilitation centres.
POPULATION: Patients with a referral for physiotherapy indicating musculoskeletal complaints of the spine or extremities.
METHODS: Translation and cross-cultural adaptation were carried out in accordance with guidelines provided by the developers. As reference standards we used pain intensity (0-10 numeric rating scale), quality of life (EQ5D-5L) and disability measures (RMDQ, NDI, WOMAC and SPADI) that were combined using z-scores.
RESULTS: On 100 patients (age 44.8±13.4 years, 66% female) the test-retest-reliability intraclass correlation coefficient was 0.87 (95% CI 0.72; 0.93) and for construct validity correlation with the combined disability measure was rs = -0.81 (95% CI -0.88, -0.72), the SEM was 3.4, the SDC (individual) 9.4, and the MIC 8.5.
CONCLUSIONS: Overall, the study provides evidence for good reliability and validity for the MSK-HQG. Further studies in different settings and diagnostic subgroups should follow to better understand the psychometric properties of this measure in primary care, rehabilitation and specialist care settings.
CLINICAL REHABILITATION IMPACT: The results demonstrate that the MSK-HQG has sufficient psychometric properties for use in musculoskeletal research and practice. However, the SDC should be kept in mind when using the tool for individual patients. The MSK-HQG has the advantage of being a single instrument that can measure musculoskeletal health status across different pain sites, reducing the burden from the use of multiple tools.

KEY WORDS: Patient reported outcomes; Psychometrics; Musculoskeletal diseases; Responsiveness

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