Table of Contents
Abstract
Musculoskeletal conditions represent a massive global health burden, frequently resulting in chronic pain, diminished mobility, and long-term disability. Historically, clinical assessments for these disorders have prioritized objective physical metrics—such as joint range of motion or muscle strength—while inadvertently sidelining the patient's lived experience. To bridge this gap, the Musculoskeletal Health Questionnaire (MSK-HQ) was originally developed in the United Kingdom as a comprehensive Patient-Reported Outcome Measure (PROM). It is designed to capture a holistic snapshot of a patient's musculoskeletal health, regardless of the specific anatomical location of their pain or their current stage in the healthcare pathway.
The adaptation of this instrument into Arabic (MSK-HQ-Ar) represents a critical step forward for cross-cultural psychometrics and global health assessment. By translating and culturally validating this 14-item questionnaire, researchers have provided Arabic-speaking clinicians with a robust tool to evaluate how musculoskeletal issues interfere with daily life, sleep, and emotional well-being. The availability of the MSK-HQ-Ar not only facilitates better patient-centered care in the Middle East but also enables standardized cross-cultural comparisons in international musculoskeletal research.
📊 Psychometric Scorecard
14
Multidimensional
0.88
📍 Saudi Arabia
Authors
Purpose
The primary objective behind adapting the MSK-HQ into Arabic was to address a significant void in the availability of culturally validated, patient-centric assessment tools in the Middle East. While Musculoskeletal Disorders are highly prevalent in regions like Saudi Arabia, local healthcare systems have often lacked standardized instruments to track patient outcomes across different care settings. This deficit can lead to fragmented care and a failure to capture the true impact of therapeutic interventions from the patient's perspective.
By providing a rigorously translated and validated Arabic version of the MSK-HQ, researchers and clinicians now have a unified metric to assess treatment efficacy. This tool is particularly valuable because it shifts the clinical focus from purely biomechanical outcomes to broader quality-of-life indicators. For graduate students and psychometricians, this adaptation underscores the importance of cross-cultural equivalence in psychological measurement—demonstrating that a tool must not only be linguistically translated but also conceptually aligned with the target population's cultural context.
Construct
The MSK-HQ-Ar measures the overarching construct of 'musculoskeletal health,' which is conceptualized as a multidimensional state of physical, emotional, and social well-being in the context of musculoskeletal conditions. Rather than treating pain as an isolated symptom, this construct recognizes that Musculoskeletal Disorders exert a cascading effect on multiple facets of a person's life. The instrument captures this complexity by evaluating several interconnected domains, including the severity of physical pain, limitations in daily functioning, and the degree to which the condition interferes with work and social obligations.
Furthermore, the construct integrates critical psychosocial dimensions that are often overlooked in traditional orthopedic assessments. These include sleep disturbances, systemic fatigue, and the emotional toll of living with chronic discomfort. Importantly, it also measures self-efficacy by assessing the patient's understanding of their condition and their confidence in self-managing their symptoms. Together, these elements form a comprehensive profile of Health-Related Quality of Life specific to musculoskeletal populations.
Validity
To establish the construct validity of the Arabic adaptation, researchers examined how well the MSK-HQ-Ar scores aligned with an established, generalized measure of health status: the EQ-5D-5L. In psychometric terms, convergent validity is supported when a new instrument demonstrates a strong relationship with an existing, validated tool that measures a theoretically related construct. The analysis revealed a robust positive correlation between the two scales, indicating that higher self-reported musculoskeletal health on the MSK-HQ-Ar accurately reflects better overall Health-Related Quality of Life.
This strong association confirms that the translated items successfully capture the intended clinical phenomena. For practitioners, this means the MSK-HQ-Ar is not just a collection of arbitrary questions, but a scientifically sound proxy for a patient's overall well-being. The fact that the adaptation process yielded validity coefficients comparable to the original English version further solidifies its utility as a culturally equivalent measurement tool.
Convergent & Discriminant Validation Correlations
| Reference Instrument | Correlation Coefficient (r) |
|---|---|
| European quality of life five-dimension, five-level scale (EQ-5D-5L) | Rho=0.711 |
Reliability
The reliability profile of the MSK-HQ-Ar demonstrates excellent psychometric stability, which is crucial for any instrument intended to monitor patient progress over time. Internal consistency was evaluated using Cronbach's alpha, yielding a strong coefficient of 0.88. This indicates that the 14 items are highly cohesive and reliably measure the same underlying construct of musculoskeletal health. This level of internal reliability mirrors the performance of both the original English and other translated versions, confirming that the Arabic translation maintained the structural integrity of the scale.
Beyond internal consistency, the instrument showed exceptional test-retest reliability over a two-week interval, with an intraclass correlation coefficient of 0.94. This temporal stability is vital; it assures clinicians that fluctuations in a patient's score reflect genuine changes in their clinical status rather than measurement error. Additionally, the researchers calculated the Standard Error of Measurement (2.46) and the Minimal Detectable Change (6.8). These metrics are particularly valuable in clinical practice, as they provide a specific numerical threshold required to confidently determine that a patient has experienced a true, clinically meaningful improvement.
Factor Analysis
While the primary focus of this validation study was on internal consistency and Cross-cultural adaptation rather than structural equation modeling, the researchers evaluated the instrument's structural coherence through detailed item-total correlations. This analytical approach helps determine how well each individual question contributes to the overall construct of musculoskeletal health. The findings revealed a strong degree of homogeneity among the items, indicating that they collectively measure a unified trait.
Interestingly, the item assessing the condition's interference with work and daily routines demonstrated the strongest correlation with the total score, highlighting the profound impact that functional impairment has on overall musculoskeletal well-being. Conversely, the item measuring the patient's understanding of their condition showed the weakest correlation. This pattern perfectly mirrors the psychometric behavior of the original English version, providing compelling evidence that the underlying factor structure and item dynamics were successfully preserved during the translation and cultural adaptation process.
Instrument
| Test Type | Self-report questionnaire |
| Format | 14 items, 5-point Likert scale |
| Scoring | Total score calculated from item responses |
| Language | Arabic |
| Population | Clinical patients |
| Age Group | 18-65 years |
| Administration | Self-administered |
| Completion Time | Requires approximately two additional minutes compared to standard short-form surveys |
Scoring & Interpretation Guidelines
| Normative Reference Values | Mean = 32.29 (SD = 10.42) |
Arabic Version of the Musculoskeletal Health Questionnaire Items
Items are currently not available
The individual items of this scale are not publicly available. Researchers interested in using this instrument should contact the original authors directly to request the scale materials.
Sample
149 patients with Musculoskeletal Disorders (84 male, 65 female) aged 18 to 65 (mean age = 43.6, SD = 13.6) recruited from Taif, Saudi Arabia.
Cite This Paper
Fahad Saad Algarni, Abdulmajeed Nasser Alotaibi, Abdulrahman Mohammed Altowaijri, Hana Al-Sobayel (2020). Arabic Version of the Musculoskeletal Health Questionnaire. International journal of environmental research and public health. https://doi.org/10.3390/ijerph17145168
References
29 references
- Woolf (2012). The need to address the burden of musculoskeletal conditions. Best Pract. Res. Clin. Rheumatol., 26 183. 🔗 https://doi.org/10.1016/j.berh.2012.03.005
- Osborne (2010). Musculoskeletal Disorders among Irish farmers. Occup Med., 60 598. 🔗 https://doi.org/10.1093/occmed/kqq146
- Menzel (2007). Psychosocial factors in Musculoskeletal Disorders. Crit. Care Nurs. Clin. N. Am., 19 145. 🔗 https://doi.org/10.1016/j.ccell.2007.02.006
- Hayes (2009). A systematic review of Musculoskeletal Disorders among dental professionals. Int. J. Dent. Hyg., 7 159. 🔗 https://doi.org/10.1111/j.1601-5037.2009.00395.x
- (1998). The Bone and Joint Decade 2000-2010. Inaugural meeting 17 and 18 April 1998, Lund, Sweden. Acta Orthop. Scand. Suppl., 281 67.
- Bevan (2015). Economic impact of Musculoskeletal Disorders (MSDs) on work in Europe. Best Pr. Res. Clin. Rheumatol., 29 356. 🔗 https://doi.org/10.1016/j.berh.2015.08.002
- Steenstra, I.A., Anema, J.R., Bongers, P.M., de Vet, H.C., and van Mechelen, W. (2003). Cost effectiveness of a multi-stage return to work program for workers on sick leave due to low back pain, design of a population based controlled trial [ISRCTN60233560]. BMC Musculoskelet. Disord., 4. 🔗 https://doi.org/10.1186/1471-2474-4-26
- Badley (1994). Relative importance of Musculoskeletal Disorders as a cause of chronic health problems, disability, and health care utilization: Findings from the 1990 Ontario Health Survey. Rheumatology, 21 505.
- Abduljabbar (2008). Musculoskeletal Disorders among dentists in Saudi Arabia. PODJ, 28 135.
- Abdulmonem (2014). The prevalence of musculoskeletal pain & its associated factors among female Saudi school teachers. PJMS, 30 1191.
- Alghadir (2015). Prevalence of musculoskeletal pain in construction workers in Saudi Arabia. Sci. World J., 2015 1. 🔗 https://doi.org/10.1155/2015/529873
- Memish (2014). Burden of disease, injuries, and risk factors in the Kingdom of Saudi Arabia, 1990–2010. Prev. Chronic Dis., 11 11. 🔗 https://doi.org/10.5888/pcd11.140176
- Shariat (2018). Effects of stretching exercise training and ergonomic modifications on musculoskeletal discomforts of office workers: A randomized controlled trial. Braz. J. Phys. Ther., 22 144. 🔗 https://doi.org/10.1016/j.bjpt.2017.09.003
- Jette (1997). Physical therapy treatment choices for musculoskeletal impairments. Phys. Ther., 77 145. 🔗 https://doi.org/10.1093/ptj/77.2.145
- Stokes (2008). Use of outcome measures in physiotherapy practice in Ireland from 1998 to 2003 and comparison to Canadian trends. Physiother. Can., 60 109. 🔗 https://doi.org/10.3138/physio.60.2.109
- Marshall (2006). Impact of patient-reported outcome measures on routine practice: A structured review. J. Evaluation Clin. Pr., 12 559. 🔗 https://doi.org/10.1111/j.1365-2753.2006.00650.x
- Hill (2016). Development and initial cohort validation of the Arthritis Research UK Musculoskeletal Health Questionnaire (MSK-HQ) for use across musculoskeletal care pathways. BMJ Open, 6 e012331. 🔗 https://doi.org/10.1136/bmjopen-2016-012331
- Herdman (2002). Cross-cultural adaptation to Spanish of the Vécu et Santé Perçue de l’Adolescent (VSP-A): A generic measure of the quality of life of adolescents. Rev. Esp. Salud Publica, 76 701.
- Beaton (2000). Guidelines for the process of Cross-cultural adaptation of self-report measures. Spine, 25 3186. 🔗 https://doi.org/10.1097/00007632-200012150-00014
- Wild (2005). Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: Report of the ISPOR Task Force for Translation and Cultural Adaptation. Value Health, 8 94. 🔗 https://doi.org/10.1111/j.1524-4733.2005.04054.x
- Shoukri (2004). Sample size requirements for the design of reliability study: Review and new results. Stat. Methods Med. Res., 13 251. 🔗 https://doi.org/10.1191/0962280204sm365ra
- Gerlinger, C., Bamber, L., Leverkus, F., Schwenke, C., Haberland, C., Schmidt, G., and Endrikat, J. (2019). Comparing the EQ-5D-5L utility index based on value sets of different countries: Impact on the interpretation of clinical study results. BMC Res. Notes, 12. 🔗 https://doi.org/10.1186/s13104-019-4067-9
- Gonzalez (2016). Differences in intermittent postural control between normal-weight and obese children. Gait Posture, 49 1. 🔗 https://doi.org/10.1016/j.gaitpost.2016.06.012
- Bekairy (2018). Validity and reliability of the Arabic version of the the EuroQOL (EQ-5D). A study from Saudi Arabia. Int. J. Health Sci., 12 16.
- Kamper (2009). Global Rating of Change Scales: A Review of Strengths and Weaknesses and Considerations for Design. J. Man. Manip. Ther., 17 163. 🔗 https://doi.org/10.1179/jmt.2009.17.3.163
- Galeoto (2019). Musculoskeletal Health Questionnaire: Translation, cultural adaptation and validation of the Italian version (MSK-HQ-I). Muscle Ligaments Tendons J., 9 295. 🔗 https://doi.org/10.32098/mltj.02.2019.20
- Terwee (2007). Quality criteria were proposed for measurement properties of health status questionnaires. J. Clin. Epidemiology, 60 34. 🔗 https://doi.org/10.1016/j.jclinepi.2006.03.012
- Norton (2019). Validation of the Musculoskeletal Health Questionnaire in inflammatory arthritis: A psychometric evaluation. Rheumatology, 58 45. 🔗 https://doi.org/10.1093/rheumatology/key240
- Alnahdi (2015). Cross-cultural adaptation, validity and reliability of the Arabic version of the Lower Extremity Functional Scale. Disabil. Rehabil., 38 897. 🔗 https://doi.org/10.3109/09638288.2015.1066452
Cite this article
Mohammed looti (2026). Arabic Version of the Musculoskeletal Health Questionnaire. PSYCHOLOGICAL SCALES. Retrieved from https://scales.arabpsychology.com/s/arabic-version-of-the-musculoskeletal-health-questionnaire/
Mohammed looti. "Arabic Version of the Musculoskeletal Health Questionnaire." PSYCHOLOGICAL SCALES, 14 Aug. 2026, https://scales.arabpsychology.com/s/arabic-version-of-the-musculoskeletal-health-questionnaire/.
Mohammed looti. "Arabic Version of the Musculoskeletal Health Questionnaire." PSYCHOLOGICAL SCALES, 2026. https://scales.arabpsychology.com/s/arabic-version-of-the-musculoskeletal-health-questionnaire/.
Mohammed looti (2026) 'Arabic Version of the Musculoskeletal Health Questionnaire', PSYCHOLOGICAL SCALES. Available at: https://scales.arabpsychology.com/s/arabic-version-of-the-musculoskeletal-health-questionnaire/.
[1] Mohammed looti, "Arabic Version of the Musculoskeletal Health Questionnaire," PSYCHOLOGICAL SCALES, vol. X, no. Y, ص Z-Z, August, 2026.
Mohammed looti. Arabic Version of the Musculoskeletal Health Questionnaire. PSYCHOLOGICAL SCALES. 2026;vol(issue):pages.