Structural validity of the Finnish Manchester-Oxford Foot Questionnaire (MOXFQ) using the Rasch model

Ville T Ponkilainen; Mikko Miettinen; Henrik Sandelin; Jan Lindahl; Arja H Häkkinen; Alar Toom; Tomi Tillgren; Outi Ilves; Antti O Latvala; Katri Ahonen; Timo Sirola; Mika Sampo; Olli Väistö; Jussi P Repo

doi:10.1016/j.fas.2020.02.012

Structural validity of the Finnish Manchester-Oxford Foot Questionnaire (MOXFQ) using the Rasch model

Foot Ankle Surg. 2021 Jan;27(1):93-100. doi: 10.1016/j.fas.2020.02.012. Epub 2020 Feb 26.

Authors

Ville T Ponkilainen¹, Mikko Miettinen², Henrik Sandelin³, Jan Lindahl², Arja H Häkkinen⁴, Alar Toom⁵, Tomi Tillgren⁵, Outi Ilves⁶, Antti O Latvala⁷, Katri Ahonen⁵, Timo Sirola², Mika Sampo⁸, Olli Väistö⁹, Jussi P Repo⁵

Affiliations

¹ Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland. Electronic address: ville.ponkilainen@tuni.fi.
² Department of Orthopedics and Traumatology, Helsinki University Hospital and University of Helsinki, Finland.
³ Department of Orthopedics and Traumatology, Helsinki University Hospital and University of Helsinki, Finland; Orthopaedic Department, Liverpool Hospital, Sydney, New South Wales, Australia.
⁴ Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland; Department of Physical Medicine, Central Finland Health Care District, Jyväskylä, Finland.
⁵ Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland.
⁶ Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
⁷ Department of Orthopedics and Traumatology, Oulu University Hospital, Oulu, Finland.
⁸ Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Finland.
⁹ Department of Orthopedics and Traumatology, Seinäjoki Central Hospital, Oulu, Finland.

PMID: 32122782
DOI: 10.1016/j.fas.2020.02.012

Abstract

Background: The 16-item patient-reported Manchester-Oxford Foot Questionnaire (MOXFQ) with subscales of pain, social interactions, and walking/standing has been claimed for strongest scientific evidence in measuring foot and ankle complaints. This study tests the validity of the Finnish MOXFQ for orthopaedic foot and ankle population using the Rasch analysis.

Methods: We translated the MOXFQ into Finnish and used that translation in our study. MOXFQ scores were obtained from 183 patients. Response category distribution, item fit, coverage, targeting, item dependency, ability to measure latent trait (unidimensionality), internal consistency (Cronbach's alpha), and person separation index (PSI) were analyzed.

Results: Fifteen of the items had ordered response categories and/or sufficient fit statistics. The subscales provided coverage and targeting. Some residual correlation was noted. Removing one item in the pain subscale led to a unidimensional structure. Alphas and PSIs ranged between 0.68-0.90 and 0.67-0.92, respectively.

Conclusions: Despite some infractions of the Rasch model, the instrument functioned well. The subscales of the MOXFQ are meaningful for assessing patient-reported complaints and outcomes in orthopaedic foot and ankle population.

Keywords: Ankle; Foot; MOXFQ; PROM; Patient-reported; Psychometrics; Rasch; Surgery; Validation.

Publication types

Multicenter Study

MeSH terms

Ankle Joint / physiology*
Female
Finland
Humans
Male
Middle Aged
Psychometrics / methods*
Reproducibility of Results
Surveys and Questionnaires
Translations*
Walking / physiology*