D. Monica Vidhya1, S. Sabapathy2, C. Srikesavan3, T. Ramalingam4
1Ganga Medical Centre & Hospitals Pvt Ltd, Coimbatore, Tamil Nadu, India, Department of Physiotherapy, Coimbatore, India, 2Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital Major Trauma Centre, Oxford, United Kingdom, 3University of Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), Oxford, United Kingdom, 4Sarvajanik College of Physiotherapy, Department of Physiotherapy, Surat, India

Background: The Musculoskeletal Health Questionnaire (MSK-HQ) evaluates overall musculoskeletal health in terms of symptoms and quality of life in people with musculoskeletal conditions. It has 14 questions, each scored from 0 to 4. The total score ranges from 0 to 56 with higher scores indicating better musculoskeletal health.
The Tamil MSK-HQ was developed following the linguistic and cultural validation methodology recommended by the Oxford University Innovation Limited, United Kingdom. The translated questionnaire was pilot tested in 5 people and a final version was produced.

Purpose: To determine the feasibility, internal consistency, factorial and convergent validity of the Tamil MSK-HQ.

Methods: Tamil speaking adults diagnosed with a wide range of musculoskeletal complaints and attending physiotherapy department at the Ganga Medical Centre & Hospitals in Coimbatore, South India were recruited. All participants were informed about the study purpose and signed consent was obtained before evaluation.
Participants were asked to complete the following questionnaires:
1) Tamil MSK-HQ Questionnaire;
2) Tamil Health Assessment Questionnaire (HAQ-DI);
3) Tamil EuroQoL-5D.
The HAQ evaluates the level of difficulty in performing common activities of daily life. The EQ-5D measures state of health in terms of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.
Cronbach's alpha was used to evaluate reliability or internal consistency of items of Tamil OKS. Spearman's correlation coefficient (r) was used to determine the magnitude of association between MSK, HAQ and EQ-5D. Principal component analysis with varimax rotation method was used to demonstrate factorial validity.

Results: 48 participants (males: 44%; females: 56%) with a mean age of 44.7 years (standard deviation, SD 8.6) participated. Nearly 80% of the participants had low back problem and others had knee, neck and shoulder conditions. The duration since the diagnosis of the musculoskeletal conditions ranged from less than three months and over two years.
The MSK scores ranged between 9 and 50 with a mean (SD) of 34.6 (10.2). The questionnaire demonstrated internal consistency with a Cronbach’s alpha of 0.88 (Confidence Interval, CI 0.86 to 0.88).
The Tamil MSK strongly correlated with EQ-5D index (Pearson r =0.7, p=0.000). There was a weak correlation with HAQ disability index (Pearson r = -0.32, p=0.026).
Factor analysis revealed a four-factor structure and the principal component analysis explained 69% of the total variance (Kaiser-Meyer-Olkin measure of sampling adequacy was 0.78, p =0.000). All factor loadings and communalities were above 0.45.
The Tamil MSK-HQ had no floor or ceiling effects.

Conclusion(s): The Tamil MSK-HQ demonstrated to be a feasible and valid outcome measure.

Implications: The Tamil MSK-HQ is a feasible and valid measure for use in Tamil speaking patients with musculoskeletal conditions.

Funding, acknowledgements: No funding

Keywords: Tamil MSK-HQ, Validation

Topic: Musculoskeletal

Did this work require ethics approval? Yes
Institution: Ganga Medical Centre & Hospitals Private Limited, Coimbatore, India.
Committee: Institutional Review Board
Ethics number: 43172

All authors, affiliations and abstracts have been published as submitted.

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