The musculoskeletal function assessment: establishing normative data.

Abstract

Historically, outcomes in orthopedic surgery had been assessed using clinical scores. Currently, functional outcome has become the important measure. The Musculoskeletal Function Assessment is valid and reliable, patient-assessed health status questionnaire used by physicians to determine outcomes in patients with musculoskeletal disorders. Reference values for outcomes instruments establish a baseline for evaluating patient function. What have come to be accepted as reference values for the Musculoskeletal Function Assessment were published in 1999 from a small nonpatient sample. The purpose of this prospective study was to establish normal reference values for the Musculoskeletal Function Assessment for healthy adults for a larger, randomly selected population. This is a prospective, observational study. Musculoskeletal Function Assessment data were collected from subjects within a 100-mile radius of our midwestern city. The Musculoskeletal Function Assessment questionnaire was administered to 406 participants randomly selected from public data. Data were collected over a 2-year period. There were 215 male and 191 female responders. Stratification criteria included gender, age (18-35, 36-55, and 56-89 years), and body mass index. There were 58 in age group 28-35 years, 102 in age group 36-55 year, and 246 in age group 56-89 years. The primary study measure was to compare Musculoskeletal Function Assessment scores for healthy nonpatient participants in the Midwest to the nonpatient data originally published in 1999. Musculoskeletal Function Assessment values were significantly higher, indicating poorer function, in all categories and demographics when compared with the previously reported data. This prospective study shows that our normal population's baseline function is significantly poorer than previously reported. In addition to indicating that the previously reported information possibly was incorrect, our findings suggest that temporal and/or geographic conditions may influence Musculoskeletal Function Assessment normative data. Therefore, assessing functional outcome may be a dynamic rather than a static process, requiring periodic updating to reestablish normative data.