Occupational Medicine 2007 57(4):300-301; doi:10.1093/occmed/kqm036
© The Author 2007. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
The Nordic Musculoskeletal Questionnaire
Joanne O. Crawford
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A brief history
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The Nordic Musculoskeletal Questionnaire (NMQ) was developed
from a project funded by the Nordic Council of Ministers [
1].
The aim was to develop and test a standardized questionnaire
methodology allowing comparison of low back, neck, shoulder
and general complaints for use in epidemiological studies. The
tool was not developed for clinical diagnosis.
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Description
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The NMQ can be used as a questionnaire or as a structured interview.
However, significantly higher frequencies of musculoskeletal
problems were reported when the questionnaire was administered
as part of a focused study on musculoskeletal issues and work
factors than when administered as part of a periodic general
health examination [
2].
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Items
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Section 1: a general questionnaire of 40 forced-choice items
identifying areas of the body causing musculoskeletal problems.
Completion is aided by a body map to indicate nine symptom sites
being neck, shoulders, upper back, elbows, low back, wrist/hands,
hips/thighs, knees and ankles/feet. Respondents are asked if
they have had any musculoskeletal trouble in the last 12 months
and last 7 days which has prevented normal activity.
Section 2: additional questions relating to the neck, the shoulders and the lower back further detail relevant issues. Twenty-five forced-choice questions elicit any accidents affecting each area, functional impact at home and work (change of job or duties), duration of the problem, assessment by a health professional and musculoskeletal problems in the last 7 days.
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Validity
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The reliability of the NMQ, using a test–retest methodology,
found the number of different answers ranged from 0 to 23%.
Validity tested against clinical history and the NMQ found a
range of 0 to 20% disagreement. The authors concluded this was
acceptable in a screening tool [
1]. Further trials identified
that the number of different answers between questionnaires
ranged from 7 to 26% for annual prevalence and 6 to 19% for
weekly prevalence [
3]. This research also led to a number of
improvements within the questionnaire including changing wording,
layout and administration for use in the UK.
Comparing pain in the last 7 days and clinical examination found sensitivity ranged between 66 and 92% and specificity between 71 and 88% [4]. In a further study of outpatients with a range of upper limb disorders, participants completed a Nordic style questionnaire on two occasions 1 week apart. The study identified that symptoms reporting for pain were highly repeatable and in terms of sensitivity, 0.90 for cervical spondylosis, 1.00 for shoulder capsulitis, 0.90 for lateral epicondylitis, 1.00 for carpal tunnel syndrome and 0.78 for Raynaud's phenomenon [5]. Both papers conclude that the NMQ is repeatable, sensitive and useful as a screening and surveillance tool. However, medical examination is essential to establish a clinical diagnosis.
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Key research
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The NMQ has been applied to a wide range of occupational groups
to evaluate musculoskeletal problems, including computer and
call centre workers [
6,
7], car drivers [
8], coopers in the whisky
industry [
9], nursing [
10] and forestry workers [
11].
The questionnaire is available from the original paper by Kuorinka et al. [1] and from Evaluation of Human Work, a Practical Ergonomics Methodology [12].
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References
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- Kuorinka I, Jonsson B, Kilbom A, et al. Standardized Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon (1987) 18:233–237.[CrossRef][ISI][Medline]
- Andersson K, Karlehagen S, Jonsson B. The importance of variations in questionnaire administration. Appl Ergon (1987) 18:229–232.[CrossRef][ISI][Medline]
- Dickinson CE, Campion K, Foster AF, et al. Questionnaire development—an examination of the Nordic Musculoskeletal Questionnaire. Appl Ergon (1992) 23:197–201.[CrossRef][ISI][Medline]
- Ohlsson K, Attewell RG, Johnsson B, et al. An assessment of neck and upper extremity disorders by questionnaire and clinical examination. Ergonomics (1994) 37:891–897.[Medline]
- Palmer K, Smith G, Kellingray S, et al. Repeatability and validity of an upper limb and neck discomfort questionnaire: the utility of the standardized Nordic questionnaire. Occup Med (Lond) (1999) 49:171–175.[CrossRef][Medline]
- Bergqvist U, Wolgast E, Nilsson B, et al. The influence of VDT work on musculoskeletal disorders. Ergonomics (1995) 38:754–762.[Medline]
- Cook C, Burgess-Limerick R, Chang SW. The prevalence of neck and upper extremity musculoskeletal symptoms in computer mouse users. Int J Ind Ergon (2000) 26:347–356.[CrossRef][ISI]
- Porter JM, Gyi DE. The prevalence of musculoskeletal troubles among car drivers. Occup Med (Lond) (2002) 52:4–12.[CrossRef][Medline]
- Macdonald F, Waclawski E. Upper limb disorders among coopers in the Scotch whisky industry. Occup Med (Lond) (2006) 56:232–236.[CrossRef][Medline]
- Smith DR, Wei N, Zhao L, et al. Musculoskeletal complaints and psychosocial risk factors among Chinese hospital nurses. Occup Med (Lond) (2004) 54:579–582.[CrossRef][Medline]
- Hagen KB, Magnus P, Vetlesen K. Neck/shoulder and low-back disorders in the forestry industry: relationship to work tasks and perceived psychosocial job stress. Ergonomics (1998) 41:1510–1518.[Medline]
- Wilson JR, Corlett EN. Evaluation of Human Work: A Practical Ergonomics Methodology (1992) 1st edn. London: Taylor and Francis. 563–568.
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A brief history
Description