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

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.