Developing and testing a consensus-based core set of outcome measures for rehabilitation in musculoskeletal diseases

Abstract

Objectives: Rehabilitation is important for people with musculoskeletal diseases (MSDs), and evaluating the effect of rehabilitation on both an individual and group level is advocated. A consensus concerning use of outcome measures will improve collaboration between healthcare providers, and increase the possibility of conducting meta-analyses in future research. The aim of this study was to develop a consensus-based core set of outcome measures for rehabilitation in MSDs, and to test the feasibility and responsiveness of the set.

Method: The core set was developed through a stepwise process comprising a Delphi consensus procedure, systematic literature searches, and a pilot study, including 386 patients, to test the feasibility and responsiveness of the set.

Results: The following aspects and outcome measures were selected: pain [numeric rating scale (NRS)], fatigue (NRS), physical fitness (the 30-second Sit to Stand test), mental health (Hopkins Symptom Checklist 5), daily activities (Hannover Functional Questionnaire), goal attainment (Patient-Specific Functional Scale including motivation score for baseline assessment), quality of life (5-level EuroQol 5 Dimensions), social participation (the social participation item from COOP/WONCA) and coping (Effective Musculoskeletal Consumer Scale-17). All tested outcome measures were found to be feasible, with high completion rates and acceptable score distribution. Standard response means varied from 0.3 to 0.9.

Conclusions: A consensus-based core set of patient reported outcome measures is presented for evaluating rehabilitation in MSDs. The core set is feasible and responsive for use in Norway, but needs further testing in other countries.

Acknowledgements

The MSD rehabilitation core set project was supported by Norwegian Extra Foundation for Health and Rehabilitation and the South-Eastern Norway Regional Health Authority. The authors would like to thank all participants in the Delphi group and the local project coordinators organizing the data collection in the pilot: Siv Eppeland, Sigrid Wigers, Arve Dyresen, Anne Dingsør, Bente Slungaard, Turid Østbøl Høystad, Ingvild Bø, Kjell Haavik-Nilsen, Gyri Skoglund, Anne Merete Bjørnerud, Edith Kalland, Kristin Svellingen Knudsen, Aina Næprud, Marthe Eidissen Holmeide, Ragnhild E. Helgesen, and Kari Tande. We would also like to thank all patients participating in the multicentre pilot study, and librarian Kari Engen Matre at Diakonhjemmet Hospital for performing the literature searches.

Supporting Information

Additional Supporting Information may be found in the online version of this article.

Supplementary online Appendix S1: Overview of all outcome measures included in the Delphi process and recorded minutes to complete for each measure.

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Additional information

Funding

This work was supported by the The Norwegian Extra Foundation for Health and Rehabilitation.