Nordic musculoskeletal questionnaire: assessment of the factor structure in a population of Brazilian adults

Mattos, Cândido Norberto Bronzoni de; Pattussi, Marcos Pascoal

doi:10.63231/2595-0118.20250001-pt

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ORIGINAL ARTICLE • Brazilian Journal of Pain 8 • 2025 • https://doi.org/10.63231/2595-0118.20250001-en linkcopy

Nordic musculoskeletal questionnaire: assessment of the factor structure in a population of Brazilian adults

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND AND OBJECTIVES The increasing presence of musculoskeletal symptoms in the general population emphasizes the importance of the study. The objective of this study is to evaluate the factorial structure of the Nordic Musculoskeletal Questionnaire (NMQ) in a sample of Brazilian adults.

METHODS A validation study was carried out with a cross-sectional sample, which is part of a larger project with a prospective cohort design (n=571). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) of the tool were performed.

RESULTS The EFA showed a similar adjustment in solutions with one or two factors in all indicators. The fit values in the CFA for both models showed Chi-square p<0.001 and Standardized Root Mean Square Residual and Root Mean Square Error Approximation values indicating good fit.

CONCLUSION The results of the exploratory and confirmatory analysis demonstrated that the tool can be used as a single factor or in a two-factor solution (upper region and lower region).

Keywords:
Cross-sectional studies; Musculoskeletal pain; Validation study

HIGHLIGHTS

Validation study in a population-based sample

An exploratory factor analysis was carried out

A confirmatory factor analysis was carried out

Demographic variables	2013-2018
Demographic variables	n	Mean / %	CI 95%
Gender
Male	139	24.3	21.5 - 27.5
Female	432	75.7	72.5 - 78.5
Age (years)	571	54	52.3 - 55.7
Marital status
No partner	341	59.7	55.1 - 64.2
Partner	224	40.3	35.8 - 44.9
Color/race
White	441	83.4	78.0 - 87.6
Yellow/black/brown/indigenous	101	16.6	12.4 - 22.0
Socioeconomic
Income in minimum wages	571	6.1	5.3 - 7.0
Schooling in years of study	571	8.1	7.4 - 8.8
Social class
D/E	36	6.5	4.7 - 9.0
C	271	49.7	42.9 - 56.6
A/B	239	43.8	36.1 - 51.7

Location	Pain 7 days		Pain 12 months
Location	n	% (CI 95%)	n	% (CI 95%)
General	237	42.1 (36.9-47.4)	401	71.1 (66.4-75.4)
Lower back	106	18.8 (15.6-22.5)	187	33.1 (28.8-37.6)
Ankles/feet	90	16.0 (12.6-19.9)	148	26.1 (22.4-30.3)
Knees	91	16.1 (13.1-19.7)	146	25.8 (22.1-30.0)
Fists/hands	73	12.9 (10.1-16.5)	125	22.1 (18.4-26.3)
Upper back	66	11.7 (8.8-15.4)	119	21.1 (17.2-25.5)
Shoulders	60	10.6 (7.8-14.3)	103	18.2 (13.9-23.5)
Neck	55	9.8 (7.7-12.3)	93	16.5 (14.1-19.2)
Hip	47	8.3 (5.7-12.0)	74	13.1 (10.3-16.5)
Elbows	35	6.2 (4.0-9.5)	56	9.9 (6.8-14.1)

In the last week you've had problems (such as pain, tingling or numbness) in your:	Solution 1 Factor		Solution 2 Factors
	Residual Variance	Musculoskeletal symptoms General	Residual Variance	Upper region	Lower region
Neck	0.663	0.581	0.624	0.342	0.374
Shoulders	0.474	0.725	0.154	0.964	-0.105
Upper back	0.354	0.804	0.086	0.955	0.002
Elbows	0.166	0.913	0.153	0.717	0.332
Fists/Hands	0.019	0.990	0.029	0.778	0.381
Lower back	0.155	0.919	0.079	-0.124	1.000
Hip	0.053	0.973	0.036	-0.004	0.983
Knees	0.230	0.878	0.174	0.108	0.853
Ankles/feet	0.093	0.953	0.032	0.188	0.882
Adjustment and reliability indicators
Chi-squared (degrees of freedom), p-value		414 (27). p<0.001			228 (19). p<0.001
RMSEA (CI 90%)		0.159 (0.146-0.173)			0.140 (0.124-0.156)
CFI		0.947			0.971
TLI		0.929			0.945
SRMR		0.218			0.143
Correlation F1-F2		-			0.467

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[1] CI: Confidence Interval.