ABSTRACT
The purpose of this study was to investigate the measurement properties of the Short
Form 36 (SF-36) to detect real change after forefoot reconstruction surgery. Responsiveness
and minimally important change estimates were compared with those from the Manchester-Oxford
Foot Questionnaire (MOXFQ) and the American Orthopaedic Foot and Ankle Society (AOFAS)
measures. Eighty-three patients awaiting surgery were recruited. Patients completed
pre- and 12 months postoperative the SF-36 and the MOXFQ. A surgeon assessed the AOFAS
scores. The responsiveness to change was determined using the effect size (ES), the
minimal detectable change (MDC) and the minimal clinically important change. Two subscales
of the SF-36 demonstrated significant improvement, bodily pain (BP) and mental health.
Only the BP domain appeared the most responsive with an ES of 0.73. All domains of
the MOXFQ and AOFAS produced much larger effect sizes (ES > 1.5). MDC values for the
majority of the SF-36 domains fell within measurement error except for the BP domain.
Fewer patients showed significant improvement when compared with the MOXFQ pain domain.
In conclusion, the SF-36 measuring tool proved to be neither reliable nor responsive
enough to detect real change after forefoot surgery. Though the BP domain appeared
to be the most responsive, it failed to detect meaningful change when compared to
the MOXFQ-Pain and the Visual Analogue Scale.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: July 22, 2021
Footnotes
Financial Disclosure: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Conflict of Interest: On behalf of all authors, the corresponding author states that there is no conflict of interest. What is more, I confirm that the manuscript has been read and approved by all named authors and that there are no other people who satisfied the criteria for authorship but the ones listed here.
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