Musculoskeletal Health Questionnaire (MSK-HQ)

The Musculoskeletal Health Questionnaire (MSK-HQ) is a patient-reported outcome measure (PROM) developed for individuals with a wide range of musculoskeletal conditions. Its purpose is to provide clinicians with a comprehensive overview of a patient’s musculoskeletal health and to enable monitoring of progression over time¹.

Target Group

MSK-HQ is designed for adults over 18 years of age with any musculoskeletal condition³. The questionnaire is responsive to changes during the course of treatment and has been rated as relevant and easy to understand by patients².

Method

MSK-HQ evaluates patient health across 14 core domains¹:

• Pain intensity (day and night)

• Physical function (e.g., walking and dressing)

• Physical activity level

• Pain interference with daily activities and leisure

• Sleep disturbance

• Emotional well-being

• Understanding of diagnosis and treatment

• Confidence in managing pain

• Independence

• Overall impact of symptoms

Administration:

• The patient completes the questionnaire prior to starting physiotherapy or treatment.

• Each domain is scored on a 5-point Likert scale (4 = “not at all,” 0 = “very severe”).

• Items 12 and 13 are reverse-scored³.

• Total scores range from 0 to 56, with higher scores indicating better musculoskeletal health.

• The questionnaire is repeated after treatment to evaluate changes³.

Validity and Reliability

Reliability:

• Test-retest reliability: ICC = 0.84

• Internal consistency: Cronbach’s α = 0.88²

Validity:

• Convergent validity: Spearman correlation r = 0.81 against the EuroQol 5-Dimension (EQ-5D)³.

Responsiveness:

• High response rate (94.2%)²

• Normally distributed scores with no floor or ceiling effects²

Advantages

• More sensitive than EQ-5D

• Provides a holistic assessment of musculoskeletal health and quality of life

• Individual domains can be tracked over time to tailor treatment⁴

Limitations

• Does not account for disease stage within different diagnostic groups

• Some patients fail to complete the follow-up assessment (e.g., due to early discharge or lack of follow-up)

• Research in arthritic populations is still developing, limiting its current use for certain musculoskeletal conditions⁵

Conclusion

MSK-HQ is a validated and reliable questionnaire for assessing musculoskeletal health in patients with diverse conditions. It demonstrates high sensitivity and responsiveness, making it valuable for monitoring treatment progress and adapting rehabilitation strategies. However, limited evidence in disease-specific stages indicates that further validation is needed for broader application.

Sources:

1. The Arthritis Research UK Musculoskeletal Health Questionnaire Developing and piloting a generic patient reported outcome measure for us across musculoskeletal care pathways. https://versusarthritis.org/media/2180/msk-health-questionnaire-briefing-june-2016.pdf

2. Hill JC, Kang S, Benedetto E, Myers H, Blackburn S, Smith S, et al. Development and initial cohort validation of the Arthritis Research UK Musculoskeletal Health Questionnaire (MSK-HQ) for use across musculoskeletal care pathways. BMJ Open 2016 Aug;6(8):e012331

3. Price AJ, Ogollah R, Kang S, Hay E, Barker KL, Benedetto E, et al. Determining responsiveness and meaningful changes for the Musculoskeletal Health Questionnaire (MSK-HQ) for use across musculoskeletal care pathways. BMJ open 2019;9(10):e025357

4. Developing and validating the MSK-HQ Musculoskeletal Health Questionnaire [Internet]. [cited 2023 Nov 26]. Available from: https://rcc-uk.org/wp-content/uploads/2017/02/Jonathan-Hill-MSK-HQ.pdf

5. Norton S, Ellis B, Santana Suárez B, Schwank S, Fitzpatrick R, Price A, et al. Validation of the Musculoskeletal Health Questionnaire in inflammatory arthritis: a psychometric evaluation. Rheumatology. 2018 Aug 10;58(1):45–51.