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Treatment-related and Patient-related Expectations of Patients With Musculoskeletal Disorders: A Systematic Review of Published Measurement Tools

van Hartingsveld, Frank MSc* †; Ostelo, Raymond W.J.G. PhD† ‡; Cuijpers, Pim PhD§; de Vos, Rien PhD*; Riphagen, Ingrid I. MSc; de Vet, Henrica C.W. PhD

doi: 10.1097/AJP.0b013e3181e0ffd3
Original Articles

Objectives Many of the various types of treatments that are used in the rehabilitation of patients with musculoskeletal disorders (MSD) require active involvement of the patient. Patient expectations, for instance with regard to treatment, such as physical therapy, could be important prognostic factors. Behavioral interventions to modify those expectations might improve treatment outcome and prevent chronicity. To facilitate this field of research, valid and reliable measurement instruments to assess patient expectations are needed. The aim of this systematic overview was to identify all the relevant published measurement instruments and to describe their clinimetric properties.

Methods A systematic search of the relevant databases was performed, and all relevant articles were included. Two independent reviewers included the relevant articles and assessed the clinimetric properties.

Results A total of 24 measurement instruments were eligible for inclusion in the review. For most types of MSD, there was only one instrument available. Construct validity, assessed with factor analysis, was tested in two-thirds of the instruments. Other forms of construct validity (eg, convergent validity and divergent validity) were only tested in 10 of the 24 instruments. Reproducibility was only tested in 5 instruments, but the test methods were seldom satisfactory, hampering the interpretation of these results.

Discussion In summary, many instruments have been developed for the treatment of many types of MSD, but the data regarding the validity or reliability of many of the instruments included in this review are scarce. Therefore, in the first place, we strongly recommend that further research is to be carried out to assess the validity and reliability of these instruments. Secondly, it is necessary to assess the instrument's ability to detect change to be able to evaluate the effectiveness of interventions that focus on self-efficacy and outcome expectations.

*Amsterdam School for Allied Health Professions, HvA-ASHP

EMGO Institute, Department of Epidemiology and Biostatistics, VU University Medical Centre

Institute for Health Sciences

§Faculty of Psychology and Education, VU University, Amsterdam, The Netherlands

Unit for Applied Clinical Research, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway

This study received a grant from the Scientific College of Physiotherapy (WCF) of the Royal Dutch Association for Physiotherapy (KNGF) in the Netherlands knowledge transfer programme for Professional Universities (SKO), Amersfoort, Utrecht, The Netherlands.

Reprints: Frank van Hartingsveld, MSc, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands (e-mail:

Received for publication August 8, 2008; revised December 18, 2009; accepted February 1, 2010

© 2010 Lippincott Williams & Wilkins, Inc.