The Örebro Musculoskeletal Screening Questionnaire: validation of a modified primary care musculoskeletal screening tool in an acute work injured population

Abstract

The original Örebro Musculoskeletal Pain Questionnaire (original-ÖMPQ) was developed to identify patients at risk of developing persistent back pain problems and is also advocated for musculoskeletal work injured populations. It is critiqued for its informal non-clinimetric development process and narrow focus. A modified version, the Örebro Musculoskeletal Screening Questionnaire (ÖMSQ), evolved and progressed the original-ÖMPQ to broaden application and improve practicality. This study evaluated and validated the ÖMSQ clinimetric characteristics and predictive ability through a single-stage prospective observational cohort of 143 acute musculoskeletal injured workers from ten Australian physiotherapy clinics. Baseline-ÖMSQ scores were concurrently recorded with functional status and problem severity outcomes, then compared at six months along with absenteeism, costs and recovery time to 80% of pre-injury functional status. The ÖMSQ demonstrated face and content validity with high reliability (ICC(2.1) = 0.978, p < 0.001). The score range was broad (40-174 ÖMSQ-points) with normalised distribution. Factor analysis revealed a six-factor model with internal consistency α = 0.82 (construct range α = 0.26-0.83). Practical characteristics included completion and scoring times (7.5 min), missing responses (5.6%) and Flesch-Kincaid readability (sixth-grade and 70% reading-ease). Predictive ability ÖMSQ-points cut-off scores were: 114 for absenteeism, functional impairment, problem severity and high cost; 83 for no-absenteeism; and 95 for low cost. Baseline-ÖMSQ scores correlated strongly with recovery time to 80% functional status (r = 0.73, p < 0.01). The ÖMSQ was validated prospectively in an acute work-injured musculoskeletal population. The ÖMSQ cut-off scores retain the predictive capacity intent of the original-ÖMPQ and provide clinicians and insurers with identification of patients with potentially high and low risks of unfavourable outcomes.