Reliability, validity and responsiveness of the German Manchester-Oxford Foot Questionnaire (MOXFQ) in patients with foot or ankle surgery
Introduction
Patient reported outcome measurements (PROMS) can provide reliable and valid measures of patient’s degree of pain, impairment, disability, and quality of life. They are a critical tool in evaluating the efficacy of orthopaedic procedures and are increasingly used in clinical trials to assess outcomes of health care [1]. The Manchester-Oxford Foot Questionnaire (MOXFQ) is a PROM for surgery of the foot and ankle, initially assessed in patients undergoing hallux valgus surgery [2], [3]. Further evaluation provided evidence in support of the reliability and validity using data from a large sample of patients undergoing surgery of a wide range of foot or ankle conditions [4], [5]. The MOXFQ contains three sub-scores for pain, walking/standing and social interaction dimensions as well as a summary index score (MOXFQ-Index). Currently it has been translated and evaluated in English, Italian, Dutch, Turkish, Persian and Spanish [2], [6], [7], [8], [9], [10].
The aim of this study was to translate the MOXFQ into German language, culturally adapt it according to international guidelines, and to evaluate reliability, validity and responsiveness.
Section snippets
Methods
The study was approved by the local research ethics committee (ref 15-252) and performed in accordance with the Declaration of Helsinki. Written informed consent from all participants was obtained. Use and translation of the English MOXFQ has been approved by ISIS Innovation Limited.
Results
177 patients, 130 women and 47 men, with a mean age of 57 years (18–92) undergoing surgery of the foot or ankle were consecutively recruited at a single institution and completed the baseline 3–14 days before surgery (t1). On the morning before surgery (t2) 145 patients completed MOXFQ to determine reliability. 6 months after surgery (t3) 117 patients completed MOXFQ, FAOS, SF-36 and NRS to test responsiveness. 118 patients were undergoing forefoot, 56 patients hindfoot or ankle surgery.
Discussion
Patient related outcome measures have become an important tool in clinical practice and clinical trials to assess outcome of health care [1], [22]. The MOXFQ is an increasingly used PROM in foot and ankle surgery which has been extensively tested and translated into Italian, Dutch, Turkish, Persian and Spanish [2], [3], [4], [5], [6], [7], [8], [9], [10], [23], [24].
In this study the English version of the MOXFQ was cross-culturally adapted and translated to German according to the official
Conflict of interest
All authors declare that they have no conflict of interest.
Funding
There is no funding source.
Ethical approval
This article does not contain any studies with human participants or animals performed by any of the authors.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Acknowledgements
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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