An evaluation of effectiveness of the Musculoskeletal Health Questionnaire (MSK-HQ) as a measure for adults following a pain management programme


Chronic pain affects many people world-wide. It is complex and often requires a multidisciplinary approach to manage with delivery of intervention through pain management programmes. Patient-Reported Outcome Measures (PROMs) within pain management programmes are used regularly to evaluate the efficacy of interventions, monitoring a patient’s perceived progress, measure pain perception and impact on functional activities. The relatively recently developed Musculoskeletal Health Questionnaire (MSK-HQ) is beginning to be employed widely in physiotherapy settings, such as rheumatology. The aim of this evaluation is to assess whether the MSK-HQ PROM is a useful tool for physiotherapists working within a multi-disciplinary pain management setting, alongside other PROMs, such as the Tampa Scale of Kinesiophobia (TSK) and the Pain self-Efficacy Questionnaire (PSEQ).

This study evaluates whether the MSK-HQ is an effective measure of change in patient outcomes following a structured eight-week multidisciplinary intervention programme for pain management. It identifies any correlations between the MSK-HQ, TSK and the PSEQ, which are both validated PROMS.


PROM data for pre intervention, 8 weeks, one and three months post programme were previously collected from 62 patients who attended group therapy sessions in the Pain Management Clinic between 2017 and 2019. The effectiveness of MSK-HQ data was measured using Friedman’s analysis of variance test: repeated measures design for all three PROMs. To investigate whether the MSK-HQ is as an effective as the TSK and PSEQ, a correlation analysis using Spearman’s Rho was conducted. All Analysis used SPSS (V25).


Results: Sixty-two patients completed PROMS. 56 missing completely at random data points were subject to listwise deletion and data from 38 patient were analysed. TSK(p=0.008), PSEQ and MSK-HQ (p=<0.001) were all statistically significant in a Friedman's two-tailed test. Using Spearman’s Rho: MSK-HQ was not significantly correlated with PSEQ at pre programme (p=0.057, r=0.311,) or TSK (p=0.258, r=-0.188,). Post programme, MSK-HQ was not significantly correlated with TSK (r=-0.245) but was significantly associated with PSEQ, (p=0.002, r=0.481); at one-month post programme, MSK-HQ with TSK showed no significant association (r=-0.306), but was with PSEQ , (p=0.001,r=0.572). At three-month post programme, MSK-HQ was not significantly correlated with TSK, (r=-0.201), in contrast with significant association shown with PSEQ, (p=0.001, r=0.587).

Conclusion(s): The MSK-HQ was shown to be a statistically effective PROM in this evaluation of 38 patients undertaking a pain management programme. Consistency of programme effectiveness was observed across the four-measurement time-points within each PROM. When measured against validated PROMS, the PSEQ showed significant moderate correlations with the MSK-HQ but had a poor agreement with the TSK.

Cost and savings

No costs for this evaluation were incurred.


The MSK-HQ is a suitable PROM tool for physiotherapists to use in the pain management setting with statistically significant correlations observed with the PSEQ. It is shown to be effective as a stand-alone PROM to evaluate practice and to inform physiotherapist interventions with this cohort.

Top three learning points

No further information. 

Funding acknowledgements

This work was not funded.