Objective: To assess test–retest reliability, construct validity and responsiveness of the Dutch Short Musculoskeletal Function Assessment (SMFA-NL) in patients who sustained acute physical trauma. Design: A longitudinal cohort study. Setting: A level 1 trauma center in The Netherlands. Subjects: Patients who required hospital admission after sustaining an acute physical trauma. Intervention: Patients completed the SMFA-NL at six weeks, eight weeks and six months post-injury. Main measure: The measures used were The Dutch Short Musculoskeletal Function Assessment. Test–retest reliability (between six and eight weeks post-injury) using intraclass correlation coefficients, the smallest detectable change and Bland and Altman plots. Construct validity (six weeks post-injury) and responsiveness (between six weeks and six months post-injury) were evaluated using the hypothesis testing method. Results: A total of 248 patients (mean age: 46.5, SD: 13.4) participated, 145 patients completed the retest questionnaires (eight weeks) and 160 patients completed the responsiveness questionnaires (six months). The intraclass correlation coefficients indicated good to excellent reliability on all subscales (0.80 to 0.98). The smallest detectable change was 17.4 for the Upper Extremity Dysfunction subscale, 11.0 for the Lower Extremity Dysfunction subscales, 13.9 for the Problems with Daily Activities subscale and 16.5 for the Mental and Emotional Problems subscale. At group level, the smallest detectable change ranged from 1.48 to 1.96. A total of 86% of the construct validity hypotheses and 79% of the responsiveness hypotheses were confirmed. Conclusion: This study showed that the SMFA-NL has good to excellent reliability, sufficient construct validity and is able to detect change in physical function over time.
BackgroundThe Short Musculoskeletal Function Assessment (SMFA) is widely used in both research and clinical practice. Despite its frequent use, normative data of the SMFA have remained limited. Aim of this study was to gather normative data for the Dutch SMFA (SMFA-NL).MethodsThe SMFA-NL consists of two indices (function index and bother index) and four subscales (upper extremity dysfunction, lower extremity dysfunction, mental and emotional problems, and problems withdaily activities). A total of 900 patients were invited to fill in the SMFA-NL. Six age groups (18–24, 25–34, 35–44, 45–54, 55–64, and 65–75 years) were constructed. Analysis of variance, t tests, and regression analyses were used to assess age and gender effects.ResultsThe response rate was 97 %. There was a significant difference between men and women in scores on all indices and subscales (range p < 0.001 to p = 0.002), except for the upper extremity dysfunction subscale (p = 0.06). A significant interaction effect was found between gender and age for the upper extremity dysfunction subscale; a larger decrease in score with increasing age was observed for women, compared with men. Significant differences were found between age groups for the bother index (p < 0.001), lower extremity dysfunction subscale (p = 0.001), and the problems with daily activities subscale (p = 0.002).ConclusionSignificant differences in SMFA-NL scores were found between men and women and between different age groups. These SMFA-NL normative data provide an opportunity of benchmarking health status of participants with musculoskeletal disorders or injuries against their age- and gender-matched peers in the Dutch population.
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