The shortened Örebro Musculoskeletal Screening Questionnaire: Evaluation in a work-injured population

Abstract

The ֲebro Musculoskeletal Screening Questionnaire (֍SQ) is a recently validated, 21-item instrument. It modified the original ֲebro Musculoskeletal Pain Questionnaire (֍PainQ) providing broader focus and also improved development and practicality for identifying work-injured patients at-risk of persistent musculoskeletal problems. These instruments are critiqued for practicality and a shortened-version recommended. A 10-item ֍PainQ was previously proposed for low-back-pain; however, general musculoskeletal populations require a broader validated instrument. To provide this, a two-stage retrospective study was performed. Stage 1 used three phases to: determined a minimum 12-item tool was required to ensure internal consistency (a > 0.70); subsequently developed two shortened ֍SQ-12 versions from qualitative content-retention and quantitative factor analysis reductive methodologies; then calibrated both versions in a spine-cohort. Stage 2 validated and compared both versions' clinimetric properties in a general musculoskeletal-cohort to ascertain which was most appropriate. The ֍PainQ-10 and a randomly-created ֍PainQ-10 were compared post-hoc for criterion validity and factor structure. A physical therapy outpatients convenience sample (n = 279) was divided into developmental (spine = 136) and calibration (musculoskeletal = 143) cohorts. Primary outcomes were functional status, insurer-reported absenteeism and costs at six months. The qualitative-֍SQ-12 demonstrated preferred properties with higher 21-item-֍SQ correlation (r = 0.97; quantitative-֍SQ-12: r = 0.94; ֍PainQ-10: r = 0.92; ֍PainQ-10-random: r = 0.94) and improved predictive ability cut-offs for high-risk (72 ֍SQ-12 points, 60%) and low-risk (57 ֍SQ-12 points, 48%). The ֍SQ-12 content-retention version is recommended. It demonstrated suitable internal consistency, a three-factor structure and high correlation with recovery time (r = 0.73). The ֍SQ-12 will facilitate early identification and management of at-risk individuals and enable targeted intervention strategies through psychosocial informed management principles.