Responsiveness of the Manchester–Oxford foot questionnaire (MOXFQ) compared with AOFAS, SF-36 and EQ-5D assessments following foot or ankle surgery

Abstract

The responsiveness of the Manchester-Oxford Foot Questionnaire (MOXFQ) was compared with foot/ankle-specific and generic outcome measures used to assess all surgery of the foot and ankle. We recruited 671 consecutive adult patients awaiting foot or ankle surgery, of whom 427 (63.6%) were female, with a mean age of 52.8 years (18 to 89). They independently completed the MOXFQ, Short-Form 36 (SF-36) and EuroQol (EQ-5D) questionnaires pre-operatively and at a mean of nine months (3.8 to 14.4) post-operatively. Foot/ankle surgeons assessed American Orthopaedic Foot and Ankle Society (AOFAS) scores corresponding to four foot/ankle regions. A transition item measured perceived changes in foot/ankle problems post-surgery. Of 628 eligible patients proceeding to surgery, 491 (78%) completed questionnaires and 262 (42%) received clinical assessments both pre- and post-operatively. The regions receiving surgery were: multiple/whole foot in eight (1.3%), ankle/hindfoot in 292 (46.5%), mid-foot in 21 (3.3%), hallux in 196 (31.2%), and lesser toes in 111 (17.7%). Foot/ankle-specific MOXFQ, AOFAS and EQ-5D domains produced larger effect sizes (> 0.8) than any SF-36 domains, suggesting superior responsiveness. In analyses that anchored change in scores and effect sizes to patients' responses to a transition item about their foot/ankle problems, the MOXFQ performed well. The SF-36 and EQ-5D performed poorly. Similar analyses, conducted within foot-region based sub-groups of patients, found that the responsiveness of the MOXFQ was good compared with the AOFAS. This evidence supports the MOXFQ's suitability for assessing all foot and ankle surgery.

Patient satisfaction and function after bilateral ankle arthrodeses

“…At the time of review we captured the patients' pain and function using the AOFAS score. The AOFAS is a non-validated score and since this data was captured our unit has moved to routinely capturing pre and post-operative MOXFQ (Manchester and Oxford foot and ankle questionnaire), which is a validated clinical score [15].…”

Long-Term Outcome of Open Plantar Fascia Release

“…Depending on the surgeon, either a transverse or a longitudinal incision was utilized and all patients underwent a partial release from the medial attachment; however, data regarding the extent of release were incomplete. All of these subjects were then contacted by mail and invited to complete 2 patient-reported outcome questionnaires: the Manchester Oxford Foot Questionnaire (MOXFQ) [8][9][10] and the Visual Analog Scale-Foot and Ankle (VAS-FA). 27,34 Both of these are validated scores for various foot and ankle conditions, and both of these scores are split into 3 separate components as well as a combined overall score.…”

Patient-reported outcome measures in hallux valgus surgery. A review of literature

“…This also accounts for the reliability, responsiveness and MCID [29,30]. The responsiveness is higher when compared to the SF-36 [ Table 1] [29][30][31][32].…”

“…The MOXFQ has already been configured to a summary score (MOXFQ-index) [41]. This score has been validated specifically for hallux valgus surgery, and has good reliability and responsiveness [3,23,31,32,41,42]. The MCID was demonstrated by Dawson et al, for each different domain [23].…”