Bryant, Elizabeth

Canby, Guy

Finucane, Laura

McCrum, Carol

Mercer, Christopher

Moore, A.

Murtagh, Shemane

Smith, Toby

Purpose: There are no validated, stand alone, outcome measures that can be used generally within musculoskeletal (MSK) physiotherapy practice that capture the dimensions that have been shown important to evaluate following physiotherapy care. The aim of this study was to investigate the psychometric properties (reliability and validity) of the newly developed Brighton musculoskeletal Patient Reported Outcome Measure (BmPROM) in outpatient physiotherapy departments. Method: The BmPROM was devised following a detailed literature search and using a consensus nominal group involving senior MSK clinicians, academics and through patient focus groups. The outcome measure was piloted informally for face and content validity for three months and modified following feedback from patients and clinicians, then piloted informally for acceptability and face validity by a local private physiotherapy practice over a three month period. The resulting BmPROM is an eight item questionnaire that was formulated to include the major areas of importance to people with MSK problems:- quality of life, activities of daily living, leisure/social activities, pain, medication, sleep, anxiety and depression levels. Newly referred patients (aged 16+) attending physiotherapy departments with an MSK condition in NHS Trusts were invited to participate in this study. The BmPROM was assessed for reliability (n=42), validity (n=224) and responsiveness (n=25). Data analysis: Exploratory factor analysis was used to examine internal construct validity. Internal consistency was assessed using Cronbach’s alpha. Test-retest reliability was analysed using paired t-test, intraclass correlation coefficient, and the Bland-Altman method of assessing agreement for individual patients. External construct validity was examined by convergent and discriminant validity (comparing BmPROM scores with SF-36 scores). Responsiveness was examined using a paired t-test, Cohen’s D and standardised response mean.Results: 224 patients participated in this study. Exploratory factor analysis indicated that a two-factor model provides a good fit to the data. Factors were representative of ‘Functionality’ and ‘Wellbeing’. Correlations observed between the BmPROM and SF-36 domains provided evidence of convergent validity. Reliability results indicated that both subscales were internally consistent with alphas above the acceptable limits. Test-retest analyses demonstrated a high degree of reliability between ‘Functionality’ and ‘Wellbeing’ scores. The Bland-Altman analysis demonstrated that the difference between ‘Functionality’ and ‘Wellbeing’ test scores did not vary as a function of absolute test score and a high proportion of cases lay within the 95% confidence interval. Large treatment effect sizes were found for both subscales.Conclusions: In conclusion, the results of this study indicate that the BmPROM is a reliable, valid and responsive measure that can be used with patients with MSK conditions in a physiotherapy outpatient setting. Implications: A stand alone, freely available outcome measure has been developed that can be used generally within MSK physiotherapy practice to encompass the range of conditions that are treated. The BmPROM can be used as an outcome measure in clinical practice or for intervention studies <br/

University of Brighton Research Portal

Exploring the psychometric properties of the Brighton musculoskeletal patient reported outcome measure

Exploring the psychometric properties of the Brighton musculoskeletal patient reported outcome measure

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University of Brighton Research Portal