Skip to main content
Log in

Cross-cultural adaptation and validation of the Danish version of the Short Musculoskeletal Function Assessment questionnaire (SMFA)

  • Brief Communication
  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to translate and culturally adapt the Short Musculoskeletal Function Assessment (SMFA) into Danish (SMFA-DK) and assess the psychometric properties.

Methods

SMFA was translated and cross-culturally adapted according to a standardized procedure. Minor changes in the wording in three items were made to adapt to Danish conditions. Acute patients (n = 201) and rehabilitation patients (n = 231) with musculoskeletal problems aged 18–87 years were included. The following analysis were made to evaluate psychometric quality of SMFA-DK: Reliability with Chronbach’s alpha, content validity as coding according to the International Classification of Functioning, Disability and Health (ICF), floor/ceiling effects, construct validity as factor analysis, correlations between SMFA-DK and Short Form 36 and also known group method. Responsiveness and effect size were calculated.

Results

Cronbach’s alpha values were between 0.79 and 0.94. SMFA-DK captured all components of the ICF, and there were no floor/ceiling effects. Factor analysis demonstrated four subscales. SMFA-DK correlated good with the SF-36 subscales for the rehabilitation patients and lower for the newly injured patients. Effect sizes were excellent and better for SMFA-DK than for SF-36.

Conclusion

The study indicates that SMFA-DK can be a valid and responsive measure of outcome in rehabilitation settings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

References

  1. World Health Organization. (2013). How to use the ICF. A practical manual for using the International Classification of Functioning, Disability and Health (ICF). Geneva: World Health Organization.

    Google Scholar 

  2. Swiontkowski, M. F., Engelberg, R., Martin, D. P., & Agel, J. (1999). Short Musculoskeletal Function Assessment questionnaire: Validity, reliability, and responsiveness. The Journal of Bone and Joint Surgery. American volume, 81(9), 1245–1260.

    Article  CAS  PubMed  Google Scholar 

  3. Böhm, T. D., Kirschner, S., Köhler, M., Wollmerstedt, N., Walther, M., Matzer, M., et al. (2005). The German Short Musculoskeletal Function Assessment questionnaire: Reliability, validity, responsiveness, and comparison with the Short Form 36 and constant score—A prospective evaluation of patients undergoing repair for rotator cuff tear. Rheumatology International, 25(2), 86–93.

    Article  PubMed  Google Scholar 

  4. Ekholm, R., Ponzer, S., Törnkvist, H., Adami, J., & Tidermark, J. (2008). Primary radial nerve palsy in patients with acute humeral shaft fractures. Journal of Orthopaedic Trauma, 22(6), 408–414.

    Article  PubMed  Google Scholar 

  5. Ekholm, R., Tidermark, J., Törnkvist, H., Adami, J., & Ponzer, S. (2006). Outcome after closed functional treatment of humeral shaft fractures. Journal of Orthopaedic Trauma, 20(9), 591–596.

    Article  PubMed  Google Scholar 

  6. Obremskey, W. T., Cutrera, N., & Kidd, C. M. (2016). A prospective multi-center study of intramedullary nailing vs casting of stable tibial shaft fractures. Journal of Orthopaedics and Traumatology., 18, 69.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Kirschner, S., Walther, M., Böhm, D., Matzer, M., Heesen, T., Faller, H., et al. (2003). German Short Musculoskeletal Function Assessment questionnaire (SMFA-D): Comparison with the SF-36 and WOMAC in a prospective evaluation in patients with primary osteoarthritis undergoing total knee arthroplasty. Rheumatology International, 23(1), 15–20.

    CAS  PubMed  Google Scholar 

  8. Process of translation and adaptation of instruments. World Health Organization. (2005). Retrieved June 26, 2010 from http://who.int/substance_abuse/research_tools/translation/en/print/.html

  9. Tavakol, M., & Dennick, R. (2011). Making sense of Cronbach’s alpha. International Journal of Medical Education, 2, 53–55.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Bjoerner, J., Damsgaard, M., & Watt, T. (1998). Tests of data quality, scaling assumptions, and reliability of the Danish SF-36. Journal Clinical Epidemiology, 51(11), 1001–1011.

    Article  Google Scholar 

  11. Reininga, I. H. F., El Moumni, M., Bulstra, S. K., Olthof, M. G. L., Wendt, K. W., & Stevens, M. (2012). Cross-cultural adaptation of the Dutch Short Musculoskeletal Function Assessment questionnaire (SMFA-NL): Internal consistency, validity, repeatability and responsiveness. Injury, 43(6), 726–733.

    Article  PubMed  Google Scholar 

  12. Ponzer, S., Skoog, A., & Bergström, G. (2003). The Short Musculoskeletal Function Assessment questionnaire (SMFA): Cross-cultural adaptation, validity, reliability and responsiveness of the Swedish SMFA (SMFA-Swe). Acta Orthopaedica Scandinavica, 74(6), 756–763.

    Article  PubMed  Google Scholar 

  13. Guevara, C., Cook, C., Pietrobon, R., Rodríguez, G., Nunley, J., Higgins, L., et al. (2006). Validation of a Spanish version of the Short Musculoskeletal Function Assessment questionnaire (SMFA). Journal of Orthopaedic Trauma, 20(9), 623–629.

    Article  PubMed  Google Scholar 

  14. Baker, S., Neill, B., & Haddon, W. (1974). The Injury Severity Score: a method for describing patients with multiple injuries and evaluating emergency care. Journal of Trauma-Injury Infection & Critical Care, 14(3), 187–196.

    Article  CAS  Google Scholar 

  15. World Health Organization. ICF Browser.Retrieved September 2016 from http://apps.who.int/classifications/icfbrowser/Accessed

  16. Portney, L., & Watkins, M. (2009). Foundations of clinical research. Applications to practice. Upper Saddle River: Pearson Prentice Hall.

    Google Scholar 

  17. Middel, B., & van Sonderen, E. (2002). Statistical significant change versus relevant or important change in (quasi) experimental design: some conceptual and methodological problems in estimating magnitude of intervention-related change in health services research. International Journal of Integrated Care, 2, e15.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Hedbeck, C. J., Tidermark, J., Ponzer, S., Blomfeldt, R., & Bergström, G. (2011). Responsiveness of the Short Musculoskeletal Function Assessment (SMFA) in patients with femoral neck fractures. Quality of Life Research:an international journal of quality of life aspects of treatment, care and rehabilitation, 20(4), 513–521.

    Article  Google Scholar 

  19. Martin, D. P., Engelberg, R., Agel, J., & Swiontkowski, M. F. (1997). Comparison of the musculoskeletal function assessment questionnaire with the Short Form-36, the Western Ontario and McMaster Universities Osteoarthritis Index, and the Sickness Impact Profile health-status measures. The Journal of Bone and Joint Surgery. American volume, 79(9), 1323–1335.

    Article  CAS  PubMed  Google Scholar 

  20. Van Son, M. A. C., Den Oudsten, B. L., Roukema, J. A., Gosens, T., Verhofstad, M. H. J., & De Vries, J. (2014). Psychometric properties of the Dutch Short Musculoskeletal Function Assessment (SMFA) questionnaire in patients with a fracture of the upper or lower extremity. Quality of Life Research, 23(3), 917–926.

    Article  PubMed  Google Scholar 

  21. Bouffard, J., Bertrand-Charette, M., & Roy, J. (2016). Psychometric properties of the musculoskeletal function assessment and the Short Musculoskeletal Function Assessment: A systematic review. Clinical Rehabilitation, 30(4), 393–409.

    Article  PubMed  Google Scholar 

  22. de Graaf, M. W., El Moumni, M., Heineman, E., Wendt, K. W., & Reininga, I. H. F. (2015). Short Musculoskeletal Function Assessment: normative data of the Dutch population. Quality of Life Research, 24(8), 2015–2023.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Wang, Y., He, Z., Lei, L., Lin, D., Lin, Y., Wang, G., et al. (2015). Reliability and validity of the Chinese version of the Short Musculoskeletal Function Assessment questionnaire in patients with skeletal muscle injury of the upper or lower extremities. BMC Musculoskeletal Disorders, 7(16), 161.

    Article  Google Scholar 

  24. Brandt, D. E., Ho, P. S., Chan, L., & Rasch, E. K. (2014). Conceptualizing disability in US national surveys: application of the World Health Organization’s (WHO) International Classification of Functioning, Disability, and Health (ICF) framework. Quality of Life Research, 23(10), 2663s–2671s.

    Article  Google Scholar 

Download references

Acknowledgements

We wish to thank the participating patients and physiotherapists for their contribution to this study.

Funding

This study was funded financially by University College Zealand, The Danish Rheumatism Association and Aase and Ejnar Danielsen’s Foundation.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Marianne Lindahl.

Ethics declarations

Conflict of interests

All the authors declare no conflict of interests.

Informed consent

Written informed consent was obtained from all individual participants included in the study.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (PDF 168 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lindahl, M., Andersen, S., Joergensen, A. et al. Cross-cultural adaptation and validation of the Danish version of the Short Musculoskeletal Function Assessment questionnaire (SMFA). Qual Life Res 27, 267–271 (2018). https://doi.org/10.1007/s11136-017-1643-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-017-1643-0

Keywords

Navigation