Structural Validity of the Short Musculoskeletal Function Assessment in Patients With Injuries

Graaf, Max W. de; Reininga, Inge H. F.; Wendt, Klaus W.; Heineman, Erik; Moumni, Mostafa El

doi:10.1093/ptj/pzy098

Cited by 7 publications

(9 citation statements)

References 30 publications

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“…[4][5][6][7][8][9] The two indices were originally reported to be valid, reliable and responsive, 10,11 although recently the Function and Bother indices were shown to have insufficient structural validity in Dutch trauma patients using the SMFA-NL. 12 The findings indicated that the two indices are not a valid representation of the latent construct physical functioning. Only a four-subscale configuration consisting of the subscales Upper Extremity Dysfunction, Lower Extremity Dysfunction, Problems with Daily Activities and Mental and Emotional Problems demonstrated sufficient structural validity.…”

Section: Introductionmentioning

confidence: 94%

“…Only a four-subscale configuration consisting of the subscales Upper Extremity Dysfunction, Lower Extremity Dysfunction, Problems with Daily Activities and Mental and Emotional Problems demonstrated sufficient structural validity. 12 Although the four-subscale structure showed sufficient structural validity in a broad range of trauma patients, additional clinimetric properties (reliability, construct validity and responsiveness ) have not yet been evaluated. Evaluation of these properties is required to justify usage in clinical and research settings.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Short Musculoskeletal Function Assessment: a study of the reliability, construct validity and responsiveness in patients sustaining trauma

et al. 2019

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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.

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Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

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The Short Musculoskeletal Function Assessment: a study of the reliability, construct validity and responsiveness in patients sustaining trauma

et al. 2019

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“…The SMFA contains 46 items that are scored on a five-point Likert scale. The Dutch SMFA-NL consists of four subscales: Upper Extremity Dysfunction, Lower Extremity Dysfunction, Problems with Daily Activities and Mental and Emotional Problems [ 13 , 14 ]. Scores range from 0 to 100.…”

Section: Methodsmentioning

confidence: 99%

“…Patients received the standard SMFA-NL. The SMFA-NL uses the same items as the original American SMFA, but uses a different factor structure [ 14 ] . The clinimetric properties of the SMFA-NL have been shown to be sufficient in patients with traumatic injuries [ 14 , 15 ].…”

Section: Methodsmentioning

confidence: 99%

Minimal important change in physical function in trauma patients: a study using the short musculoskeletal function assessment

et al. 2020

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Purpose The Short Musculoskeletal Function Assessment (SMFA) questionnaire can be used to evaluate physical functioning in patients with traumatic injuries. It is not known what change in score reflects a meaningful change to patients. The aim was to determine minimal important change (MIC) values of the subscales (0-100) of the Dutch SMFA-NL in a sample of patients with a broad range of injuries. Methods Patients between 18 and 65 years of age completed the SMFA-NL and the Global Rating of Effect (GRE) questions at 6-week and 12-month post-injury. Anchor-based MIC values were calculated using univariable logistic regression analyses. Results A total of 225 patients were included (response rate 67%). The MIC value of the Upper Extremity Dysfunction (UED) subscale was 8 points, with a misclassification rate of 43%. The Lower Extremity Dysfunction subscale MIC value was 14 points, with a misclassification rate of 29%. The MIC value of the Problems with Daily Activities subscale was 25 points, with a misclassification rate of 33%. The MIC value of the Mental and Emotional Problems (MEP) subscale was 7 points, with a misclassification rate 37%. Conclusion MIC values of the SMFA-NL were determined. The MIC values aid interpreting whether a change in physical functioning can be considered clinically important. Due to the considerable rates of misclassification, the MIC values of the UED and MEP subscales should be used with caution.

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The effect of age on resilience of health-related quality of life among polytrauma patients: a cross-sectional multicenter study

Vries

Reininga

Graaf

et al. 2022

Eur J Trauma Emerg Surg

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Purpose The aim of this study was to determine the impact of age on patient-reported health-related quality of life (HRQoL) and the capacity to show resilience—i.e., the ability to adapt to stressful adverse events—after sustaining a polytrauma. Methods A cross-sectional multicenter cohort was conducted between 2013 and 2016 that included surviving polytrauma patients (ISS ≥ 16). HRQoL was obtained by the Short Musculoskeletal Function assessment and EuroQol (SMFA and EQ-5D-5L). The effect of age on HRQoL was tested with linear regression analysis. Next, the individual scores were compared with age- and sex-matched normative data to determine whether they showed resilience. Multivariate binary logistic regression was used to assess the effect of age on reaching the normative threshold of the surveys, correcting for several confounders. Results A total of 363 patients responded (57%). Overall, patients had a mean EQ-5D-5L score of 0.73. With higher age, scores on the SMFA subscales “upper extremity dysfunction,” “lower extremity dysfunction” and “daily activities” significantly dropped. Only 42% of patients were classified as being resilient, based on the EQ-5D-5L score. Patients aged 60–69 showed the highest resilience (56%), and those aged 80 + showed the lowest resilience (0%). Conclusion Sustaining a polytrauma leads to a serious decline in HRQoL. Aging is associated with a decline in the physical components of HRQoL. No clear relationship with age was seen on the non-physical components of quality of life. Octogenarians, and to a lesser extent septuagenarians and tricenarians, showed to be very vulnerable groups, with low rates of resilience after surviving a polytrauma.

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Structural Validity of the Short Musculoskeletal Function Assessment in Patients With Injuries

Abstract: In a broad range of patients with injuries, the SMFA-NL may be best scored and interpreted using a 4-factor structure. Other factor structures showed insufficient structural validity.

Cited by 7 publications

References 30 publications

The Short Musculoskeletal Function Assessment: a study of the reliability, construct validity and responsiveness in patients sustaining trauma

The Short Musculoskeletal Function Assessment: a study of the reliability, construct validity and responsiveness in patients sustaining trauma

Minimal important change in physical function in trauma patients: a study using the short musculoskeletal function assessment

The effect of age on resilience of health-related quality of life among polytrauma patients: a cross-sectional multicenter study

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