Musculoskeletal measures

Back and lower limb

Hip Disability and Osteoarthritis Score (HOOS)

Link

• Access the Hip Disability and Osteoarthritis Score (HOOS) in PDF format, online format 1 or online format 2.

Type

• Evaluative

Description

• Explores how the hip condition is impacting on the person and can be used to monitor changes in hip function, pain and quality of life with treatment interventions.

Advantages

• Can be completed and scored online.
• More responsive than the WOMAC.
• Available in over 20 languages.

Precautions or limitations

• Can take up to 15 minutes to complete.
• Complex to score if not done online.

International Hip Outcome Tool-33 (iHOT-33)

Link

• Access the International Hip Outcome Tool-33 (iHOT-33) in PDF format.

Type

• Evaluative

Description

• Measures change in hip-related quality of life in adults with hip and groin pain. See article.

Advantages

• The four subscales can be used independently or combined as a total score.
• Valid and reliable in people undergoing conservative treatment as well as hip arthroscopy.
• Responsive to change with established minimal detectable change scores.

Precautions or limitations

• Can take up to 15 minutes to complete.
• Manual scoring can be time burdensome (5 to 10 minutes).

Lower Extremity Functional Scale (LEFS)

Link

• Access the Lower Extremity Functional Scale (LEFS)

Type

• Evaluative

Description

• Can be used to monitor changes in functioning during treatment interventions. A change in score of 9 points or more is likely to represent a clinically meaningful change (MCID).

Advantages

• Quick to complete.
• Can be used for different joints and multiple joints in the lower limb.

Precautions or limitations

• A number of the activities are quite high level and some clients will never be able to do them, which may contribute to a floor effect.

Foot and Ankle Disability Index (FADI)

Link

• Access the Foot and Ankle Disability Index (FADI) in PDF format or online format.

Type

• Evaluative

Description

• Measures foot and ankle symptoms and functioning.

Advantages

• Designed with chronic ankle instability in mind so may be relevant to people who have experienced ankle trauma in a MVA. A change in score of at least 3 points, but preferably 4.5, is likely to represent a clinically meaningful change (MCID).
• Has an additional sports component for more high functioning people.
• More specific than the LEFS and can accurately reflect the person's functional situation.
• Can be completed and scored online.

Precautions or limitations

• None of note.

Québec Back Pain Disability Scale (QBPDS)

Link

• Access the Québec Back Pain Disability Scale (QBPDS)

Type

• Evaluative

Description

• Explores functioning as the focus (rather than pain) in people with back pain.
• Measures the efficacy of treatment, gives a baseline of the impact of the low back condition on the person and measures the impact of any intervention on their function. MDC90 is 19 points (score range = 100 points).

Advantages

• Easy and quick to use and score.

Precautions or limitations

• The MDC90 is large which means that there needs to be an even larger change in score to be certain that the change is greater than the inherent error of the measurement tool itself.

Back Bournemouth Questionnaire

Link

• Access the Back Bournemouth Questionnaire in PDF format

Type

• Evaluative

Description

• Explores pain, disability and psychosocial impacts of back pain on a person.
• Measures treatment efficacy. If there is no real change in scores with treatment, consideration should be given to reviewing the diagnosis and/or the nature of the treatment provided. The MCD90 is 13 points or 36% (score range 0 to 70).

Advantages

• Brief multidimensional measure that is easy to and quick to use and score.

Precautions or limitations

• Incorporates both physical functional status with psychosocial domains within a brief questionnaire but does not involve detailed questioning in each domain.

Head, neck and upper limb

Disabilities of the Arm Shoulder and Hand (DASH)

Link

• Access the Disabilities of the Arm Shoulder and Hand (DASH) as a download or in online format.

Type

• Evaluative

Description

• Evaluates symptoms and functioning of the whole upper extremity in adults.
• Measures pain and functioning and the effect of treatment. MCID: 10 (proximal: shoulder) 17 (distal: elbow, wrist and hand).

Advantages

• Questions include all of the upper limb.
• Includes an optional high performance sport/music or work section.

Precautions or limitations

• Complex to score.

Quick DASH

Link

• Access the Quick DASH as a download or in online format.

Type

• Evaluative

Description

• Measures pain and function in the upper limb and the effect of treatment on pain and shoulder function.
• There needs to be a change in score of 10 to 19 points for the change to represent clinically important change (MCID).

Advantages

• Optional high performance items are available for sport/music and work.
• Easier to score than the original DASH.

Precautions or limitations

• At least 10 of the 11 items must be completed to calculate a score.

Shoulder Pain and Disability Index (SPADI)

Link

• Access the Shoulder Pain and Disability Index (SPADI)

Type

• Evaluative

Description

• Measures pain and functioning associated with shoulder pathology and the effect of treatment on pain and shoulder functioning. A change in score of at least 8 points represents the MCID.

Advantages

• Specific to the shoulder, so useful when this alone is the problem being treated.
• Easy to score
• Questions are simple and easy for most people to understand.

Precautions or limitations

• No psychosocial aspects are included in this outcome measure, so it should be used alongside other measures.

Upper Extremity Functional Index (UEFI)

Link

• Access the Upper Extremity Functional Index (UEFI) in PDF format or online format.

Type

• Evaluative

Description

• Evaluates upper extremity function. Measures functioning throughout the whole arm and evaluates the effect of treatment on this. A change in score of at least 9 points represents MCID.

Advantages

• Easy to administer, score and interpret.
• Easy for most people to understand.

Precautions or limitations

• Very generalised upper limb functional activities.
• May not be specific enough with some people.

Whiplash Disability Questionnaire (WDQ)

Link

• Access the Whiplash Disability Questionnaire (WDQ)

Type

• Evaluative

Description

• Examines psychosocial factors as well as pain and functioning in people who have whiplash associated disorder.
• Measures pain, functioning and yellow flags. The last 4 questions give an idea as to whether yellow flags are present. If the overall score is high, then clinician needs to be aware that manual therapy alone is inadequate. Can be used to measure treatment efficacy. The MDC90 is 15 points. (score range = 130)

Advantages

• Easy to administer, score and interpret.
• Easy for patients to understand.
• Easy for people with limited English language literacy skills.
• Developed for an Australian cohort and condition specific.

Precautions or limitations

• None of note.

Headache Disability Index (HDI)

Link

• Access the Headache Disability Index (HDI)

Type

• Evaluative

Description

• Explores functioning and changes in functioning in people with subacute and chronic cervicogenic headache.
• Measures treatment efficacy. If no real change with treatment then the clinician should question the diagnosis of cervicogenic headache and choice of treatment. The MDC95 is a 29-point change or greater in the total score (score range = 100).

Advantages

• Easy and quick to use and score.

Precautions or limitations

• This is for cervicogenic headache. A large change needs to occur in scoring for it to be able to be considered greater than the error of this measurement tool.

Neck Disability Index (NDI)

Link

• Access the Neck Disability Index (NDI) in PDF format or online format.

Type

• Evaluative

Description

• Explores functioning and changes in functioning in people with neck pain.
• Measures treatment efficacy. If there is no real change with treatment, clinician should question diagnosis and choice of treatment. MDC90 is 10 points (score range = 100)

Advantages

• Easy and quick to use and score.

Precautions or limitations

• Pain and its impact are the major focus.
• May be difficult for people with limited English language literacy skills to discriminate between each of the response categories.
• Should be used in conjunction with other measures more biased towards psychosocial items.
• Can be subject to ceiling effects.

Neck Bournemouth Questionnaire

Link

• Access the Neck Bournemouth Questionnaire in PDF format

Type

• Evaluative

Description

• Explores pain, disability and psychosocial impacts of neck pain on a person.
• Measures treatment efficacy. If there is no real change in scores with treatment, consideration should be given to reviewing the diagnosis and/or the nature of the treatment provided. The MCD90 is 12 points (score range 0 to 70).

Advantages

• Brief multidimensional measure that is easy to and quick to use and score.

Precautions or limitations

• Incorporates both physical functional status with psychosocial domains within a brief questionnaire but does not involve detailed questioning in each domain.