Michigan Hand Outcomes Questionnaire (MHQ)

How is the MHQ scored?

The MHQ contains six domains:

• Overall hand function
• Activities of daily living
• Work performance
• Pain
• Aesthetics
• Satisfaction

​An overall MHQ score can be obtained by summing the scores for all six scales after reversing the pain scale (pain=100-pain score) and then dividing by six.

In the pain scale, high scores indicate greater pain, while in the other five scales, high scores denote better hand performance.

​The score for the affected hand is obtained by selecting either the right or the left hand score. If both hands are affected (ex. rheumatoid arthritis patients), the right and left hand scores are averaged to get the score.

The raw scale score for each of the six scales is the sum of the responses of each scale item. The raw score is converted to a score ranging from 0-100. Detailed instructions are provided here. Furthermore, a scoring algorithm in SAS and Excel are also provided when you apply for a license. If you have any questions, please contact us here.​

Missing values in each scale may affect the validity of the scores. If 50% or more of the items in a scale are missing, then that particular scale cannot be scored. For scales with less than 50% missing, the average of the existing scale items may be imputed for the missing items. For example, the Aesthetics scale has 4 questions.

If only 2 questions are answered and 2 are missing the scale cannot be scored because 50% of the responses are missing. If 3 questions are answered and 1 is missing, the responses for the answered questions are averaged and this average value is entered as the value for the missing response. The scale is then score as usual.

An overall MHQ score can be obtained by summing the scores for all six scales after reversing the pain scale (pain=100-pain score) and then dividing by six.

Scoring the MHQ

To use the SAS mechanism you must arrange your data according to the variable names indicated in the codebook. You may then open the mechanism in the SAS program and replace the file names where indicated.​

To use the Excel mechanism, enter an “x” in the appropriate boxes. The scores are computed at the bottom of the spreadsheet. Please note: The Excel scoring mechanism cannot accommodate missing values!

MHQ Scoring Algorithm

*The response categories for some of the questions are reversed and recoded. Please be sure to do this step before calculating raw score.

**Sum of the responses for each hand on each scale.

***For the pain scale, higher scores indicate more pain. For the other five scales, higher scores indicate better hand performance. The scores are normalized to a range of 0 to 100.

To calculate overall MHQ score use the following formula with normalized scores. Be sure to reverse the pain score:

Overall MHQ Score per hand = [Function + Activities of Daily Living + Work + (100-Pain) + Aesthetics + Satisfaction]/6

The score for the affected hand is obtained by selecting either the right or the left hand score. The “affected” hand score can be compared to the “normal’ hand score. If both hands are affected (ex. rheumatoid arthritis patients), the right and left hand scores are averaged to get the score.

​Missing Values:

Missing values in each scale may affect the validity of the scores. If 50% or more of the items in a scale are missing, then that particular scale cannot be scored. For scales with less than 50% missing, the average of the existing scale items may be imputed for the missing items. For example, the Aesthetics scale has 4 questions, if only 2 questions are answered and 2 are missing the scale cannot be scored because 50% of the responses are missing. If 3 questions are answered and 1 is missing, the responses for the answered questions are averaged and this average value is entered as the value for the missing response. The scale is then scored as usual.

General Clinimetrics​

Chung KC, Hamill JB, Walters MR, Hayward RA. The Michigan Hand Outcomes Questionnaire (MHQ): assessment of responsiveness to clinical change. Ann Plast Surg. 42(6):619-22, 1999.

Chung KC, Pillsbury MS, Walters MR, Hayward RA. Reliability and validity testing of the Michigan Hand Outcomes Questionnaire. J Hand Surg Am. 23:575-87, 1998.

Chung BT, Morris SF. Reliability and internal validity of the Michigan Hand Questionnaire. Ann Plast Surg. 73(4):385-9, 2014.

Chung BT, Morris SF. Confirmatory Factor Analysis of the Michigan Hand Questionnaire. Ann Plast Surg. 74(2):176-81, 2015.

Dias JJ, Rajan RA, Thompson JR. Which questionnaire is best? The reliability, validity and ease of use of the Patient Evaluation Measure, the Disabilities of the Arm, Shoulder and Hand and the Michigan Hand Outcome Measure. J Hand Surg Am. 33:9-17, 2008.

Lee D, Paulson A, Sanghavi K, Giladi AM. Responsiveness of the Brief Michigan Hand Outcomes Questionnaire and Patient-Reported Outcomes Measurement Information System Pain Interference in the Context of Patient Mental Health. The Journal of Hand Surgery. https://doi.org/10.1016/j.jhsa.2022.06.010. Epub 2022 August 5.​

London DA, Stepan JG, Calfee RP. Determining the Michigan Hand Outcomes Questionnaire minimal clinically important difference by means of three methods. Plast Reconstr Surg. 133(3):616-25, 2014.

Maia MV, de Moraes VY, Dos Santos JB, Faloppa F, Belloti JC. Minimal important difference after hand surgery: a prospective assessment for DASH, MHQ, and SF-12. SICOT J. 2(32), 2016.

McMillan CR, Binhammer PA. Which Outcome Measure is the Best? Evaluating Responsiveness of the Disabilities of the Arm, Shoulder, and Hand Questionnaire, the Michigan Hand Questionnaire and the Patient-Specific Functional Scale Following Hand and Wrist Surgery. Hand. 4(3):311-8, 2009.

Nolte MT, Shauver MJ, Chung KC. Normative values of the Michigan Hand Outcomes Questionnaire for patients with and without hand conditions. Plast Reconstr Surg. 140(3):425e-33e, 2017.​

Schoneveld K, Wittink H, Takken T. Clinimetric evaluation of measurement tools used in hand therapy to assess activity and participation. J Hand Ther. 22(3):221-35, 2009.

Shauver MJ, Chung KC. The minimal clinically important difference of the Michigan Hand Outcomes Questionnaire. J Hand Surg Am. 34:509-14, 2009.

Shetty PN, Hawken J, Sanghavi KK, Giladi AM. Correlation of patient-reported outcomes measurement information system questionnaires with the brief Michigan Hand Questionnaire in patients with 5 common hand conditions. The Journal of Hand Surgery. 46(8):709.e1-709.e11, 2021.

van de Ven-Stevens L, Munneke M, Terwee CB, Spauwen PHM, van der Linde H. Clinimetric properties of instruments to assess activities in patients with hand injury: A systematic review of the literature. Arch Phys Med Rehabil. 90:151-69, 2009.

Waljee JF, Kim HM, Burns PB, Chung KC. Development of a brief, 12-item version of the Michigan Hand Questionnaire. Plast Reconstr Surg. 128:208-20, 2011.

Marks M. J Hand Surg Eur Vol. 2020 Jan;45(1):5-11. doi: 10.1177/1753193419882875. Epub 2019 Nov 5.

Wittoek R, Kroon FPB, Kundakci B, Abhishek A, Haugen IK, Berenbaum F, Conaghan PG, Ishimori ML, Smeets W, van der Heijde D, Kloppenburg M. J Rheumatol. 2019 Sep;46(9):1183-1187. doi: 10.3899/jrheum.181003. Epub 2019 Jan 15.

Wormald JCR, Geoghegan L, Sierakowski K, Price A, Peters M, Jain A, Rodrigues JN. Plast Reconstr Surg Glob Open. 2019 May 21;7(5):e2256. doi: 10.1097/GOX.0000000000002256. eCollection 2019 May.

Mahmood B, Chongshu C, Qiu X, Messing S, Hammert WC. J Hand Surg Am. 2019 May;44(5):366-373. doi: 10.1016/j.jhsa.2018.10.031. Epub 2018 Dec 21.

Dogu B, Usen A, Kuran B, Yilmaz F, Sirzai H. J Back Musculoskelet Rehabil. 2019;32(1):111-117. doi: 10.3233/BMR-181255.

Condition-specific Clinimetrics

Carpal Tunnel Syndrome

Chatterjee JS, Price PE. Comparative Responsiveness of the Michigan Hand Outcomes Questionnaire and the Carpal Tunnel Questionnaire after Carpal Tunnel Release. J Hand Surg Am. 34:273-80, 2009.

Kotsis SV, Chung KC. Responsiveness of the Michigan Hand Outcomes Questionnaire and the Disabilities of the Arm, Shoulder and Hand questionnaire in carpal tunnel surgery. J Hand Surg Am. 30:81-6, 2005.

Sambandam SN, Priyanka P, Gul A, Ilango B. Critical analysis of outcome measures used in the assessment of carpal tunnel syndrome. Int Orthop. 32(4):497-504, 2008.

Yücel H, Seyithanoğlu H. Choosing the most efficacious scoring method for carpal tunnel syndrome. Acta Orthop Traumatol Turc. 49(1):23-9, 2015.

Distal Radius Fracture

Kotsis SV. Lau FH. Chung KC. Responsiveness of the Michigan Hand Outcomes Questionnaire and physical measurements in outcome studies of distal radius fracture treatment. J Hand Surg Am. 32:84-90, 2007.

Dupuytren Contracture

​Broekstra DC, van den Heuvel ER, Lanting R, Werker PMN. Measurement properties of the Dutch Unité Rhumatologique des Affections de la Main and its ability to measure change due to Dupuytren's disease progression compared with the Michigan Hand outcomes Questionnaire. J Hand Surg Eur. 43(8):855-63, 2018.

Thoma A, Kaur MN, Ignacy TA, Levis C, Martin S, Duku E, Haines T. Psychometric properties of health-related quality of life instruments in patients undergoing palmar fasciectomy for Dupuytren's disease: a prospective study. 9(2):166-74, 2014.

Wehrli M, Hensler S, Schindele S, Herren DB, Marks M. Measurement Properties of the Brief Michigan Hand Outcomes Questionnaire in Patients With Dupuytren Contracture. J Hand Surg Am. 41(9): 896-902, 2016.

Osteoarthritis

Notermans BJW, van der Oest MJW, Selles RW, de Boer LHL. Hand-Wrist Study Group, van der Heijden BEPA. Patient-Reported Outcomes 1 Year After Proximal Interphalangeal Joint Arthroplasty for Osteoarthritis. J Hand Surg Am. 47(7):603-610, 2022.

Kroon FPB, Boersma A, Boonen A, van Beest S, Damman W, van der Heijde D, Rosendaal FR, Kloppenburg M. Performance of the Michigan Hand Outcomes Questionnaire in hand osteoarthritis. Osteoarthritis Cartilage. Epub ahead of print Aug 9, 2018.​

Marks M, Hensler S, Wehrli M, Schindele S, Herren DB. Minimal important change and patient acceptable symptom state for patients after proximal interphalangeal joint arthroplasty. J Hand Surg Eur. Epub ahead of print Sept 14, 2018.

McPhail SM, Bagraith KS, Schippers M, Wells PJ, Hatton A. Use of Condition-Specific Patient-Reported Outcome Measures in Clinical Trials among Patients with Wrist Osteoarthritis: A Systematic Review. Adv Orthop. Epub ahead of print Nov 1, 2012.

Poole JL. Measures of hand function: Arthritis Hand Function Test (AHFT), Australian Canadian Osteoarthritis Hand Index (AUSCAN), Cochin Hand Function Scale, Functional Index for Hand Osteoarthritis (FIHOA), Grip Ability Test (GAT), Jebsen Hand Function Test (JHFT), and Michigan Hand Outcomes Questionnaire (MHQ). Arthritis Care Res. 63:S189-199, 2011.

Rheumatoid Arthritis and other Autoimmune Diseases

​Adams J. Mullee M. Burridge J. Hammond A. Cooper C. Responsiveness of self-report and therapist-rated upper extremity structural impairment and functional outcome measures in early rheumatoid arthritis. Arthritis  Care Res. 62(2):274-8, 2010.

Belghali S, Ben Abderrahim K, Mahmoud I, Baccouche K, El Amri N, Zeglaoui H, Maaref K, Bouajina E. Brief Michigan Hand Outcomes Questionnaire in rheumatoid arthritis: A cross-sectional study of 100 patients. Hand Surg Rehabil. 36(1):24-9, 2017.

Dritsaki M, Petrou S, Williams M, Lamb SE. An empirical evaluation of the SF-12, SF-6D, EQ-5D and Michigan Hand Outcomes Questionnaire in patients with rheumatoid arthritis of the hand. Health Qual Life Outcomes. 15(1):20, 2017.  

Durmas D. Uzuner B. Durmas Y. Bilgici A. Kuru O. Michigan Hand Outcomes Questionnaire in rheumatoid arthritis patients: Relationship with disease activity, quality of life, and handgrip strength. J Back Musculoskel Rehabil. 26(4):476-73, 2013.

Jayaram M, Wang C, Wang L, Chung KC. Validating the Michigan Hand Outcomes Questionnaire in patients with rheumatoid arthritis using Rasch analysis. PLoS ONE. 16(7):e0254984, 2021.

Massy-Westropp N. Krishnan J. Ahern M. Comparing the AUSCAN Osteoarthritis Hand Index, Michigan Hand Outcomes Questionnaire, and Sequential Occupational Dexterity Assessment for patients with rheumatoid arthritis. J Rheumatol. 31(10):1996-2001, 2004.

Schouffoer AA, van der Giesen FJ, Beaart-van de Voorde LJ, Wolterbeek R, Huizinga TW, Vliet Vlieland TP. Validity and responsiveness of the Michigan Hand Questionnaire in patients with systemic sclerosis. Rheumatol. 55(8):1386-93, 2016.

Waljee JF, Chung KC, Kim HM, Burns PB, Burke FD, Wilgis EF, Fox DA. Validity and responsiveness of the Michigan Hand Questionnaire in patients with rheumatoid arthritis: a multicenter, international study. Arthritis Care Res. 62(11):1569-77, 2010.

Trauma

Dogu B, Usen A, Kuran B, Yilmaz F, Sirzai H. Comparison of responsiveness of Michigan Hand Outcomes Questionnaire, Disabilities of the Arm, Shoulder and Hand Questionnaire, and Duruöz Hand Index in patients with traumatic hand injury. J Back Musculoskelet Rehabil. Epub ahead of print Sept 7, 2018.

Horng YS, Lin MC, Feng CT, Huang CH, Wu HC, Wang JD. Responsiveness of the Michigan Hand Outcomes Questionnaire and the Disabilities of the Arm, Shoulder, and Hand Questionnaire in Patients With Hand Injury. J Hand Surg Am. 35(3):430-6, 2010.

Weinstock-Zlotnick G, Page C, Ghomrawi HM, Wolff AL. Responsiveness of three Patient Report Outcome (PRO) measures in patients with hand fractures: A preliminary cohort study. J Hand Ther. 28(4):403-10, 2015.

Yoon AP, Kaur S, Chou CH, Chung KC, Malay S, Shauver M, Wang L, Zhong L, Sommers K, Hume K, Sawada H, Hsu CC, Tai-Jung T, Yang G, Zhang Z, Giladi A, Fleming I, Sabapathy SR, Kumaran MS, Ishiko T, Nishizuka T, Kawamura K, Sebastin S, Yong J, Jain S, Colvell K, Lacey M, Hillard C, Fowler J, Neumeister M, Lovel B, Kao D, Arif H, Spiess A, Grybowski D, Michelotti B, Costa B, Drolet B, Bueno RA Jr, Spear M, Woo SH, Kim YW, Moore A, Roth Bettlach C, Linkugel A, Dalton J; FRANCHISE Group. Plast Reconstr Surg. 2020 Jan;145(1):94e-105e. doi: 10.1097/PRS.0000000000006326.

Ulnar Neuropathy

​Koziej M, Trybus M, Banach M, Bednarek M, Chrapusta A, Szuścik M, Piątek-Koziej K, Tomaszewski K. Comparison of Patient-Reported Outcome Measurements and Objective Measurements after Cubital Tunnel Decompression. Plast Reconstr Surg. 141(5):1171-81, 2018.

Malay S. SUN Study Group. Chung KC. The Minimal Clinically Important Difference After Simple Decompression for Ulnar Neuropathy at the Elbow. J Hand Surg Am. 38:652-659, 2013.

Use of the MHQ outside of traditional hand surgery

Cerebral Palsy

Barden HL, Baguley IJ, Nott MT, Chapparo C. Measuring spasticity and fine motor control (pinch) change in the hand after botulinum toxin-A injection using dynamic computerized hand dynamometry. Arch Phy Med Rehabil. 95(12):2402-9, 2014.

Krekel NM, Smeulders MJ, Klaij F, Margry R, Kreulen M. [Effect of surgical treatment on patients with cerebral palsy: improvement of manual dexterity but not of perceived competence.] Nederlands Tijdschtrift voor Geneeskunde. 154:A1527, 2010.

Charcot-Marie-Tooth Disease​

Videler A, Eijffinger E, Nollet F, Beelen A. A thumb opposition splint to improve manual dexterity and upper-limb functioning in Charcot-Marie-Tooth disease. J Rehabil Med. 44(3):249-53, 2012.

Complex Regional Pain Syndrome

Huge V, Lauchart M, Magerl W, Beyer A, Moehnle P, Kaufhold W, Schelling G, Azad SC. Complex interaction of sensory and motor signs and symptoms in chronic CRPS. PLoS One. 6(4):e18775.

Vogel T, Gradl G, Ockert B, Pellengahr CS, Schürmann M. Sympathetic dysfunction in long-term complex regional pain syndrome. Clin J Pain. 26(2):128-3, 2010.

Donor Site Morbidity

Bonaparte JP, Corsten MJ, Allen M. Cosmetic and functional outcomes after preoperative tissue expansion of radial forearm free flap donor site: a cohort study. J Otolaryngol Head Neck Surg. 40(5):427-35, 2011.

Hussain A. Choukairi F. Luckraz H. Mehta D. Azzu A. Outcome Assessment of Hand Function and Patient Satisfaction Following Radial Artery Harvesting For Coronary Artery Bypass Grafting. Heart Lung. 16(Suppl 2):S177, 2007.

Jaquet Y, Enepekides DJ, Torgerson C, Higgins KM. Radial forearm free flap donor site morbidity: ulnar-based transposition flap vs split-thickness graft. Arch Otolaryngol Head Neck Surg. 138(1):38-43, 2012.

Sardesai M. Yoo JHJ. Franklin JH. Naftel CW. Denning L. Fung K. Donor site morbidity with radial forearm free flap. J Otolaryngol Head Neck Surg. 137(2S):P151-2, 2007.

Metabolic Disorders

​Matos MA, Barboza ICF, Ferraz MVAR, Hembroff G. Michigan Hand Outcomes Questionnaire for the Evaluation of Patients with Mucopolysaccharidosis. Bull Hosp Jt Dis. 76(2):112-5, 2018.

Neuropathy

​Videler AJ. Beelen A. van Schaik IN. de Visser M. Nollet F. Limited upper limb functioning has impact on restrictions in participation and autonomy of patients with hereditary motor and sensory neuropathy 1a. J Rehabil Med. 41(9):746-50, 2009.​

Yang CJ, Hsu HY, Lu CH, Chao YL, Chiu HY, Kuo  LC. The associations among hand dexterity, functional performance, and quality of life in diabetic patients with neuropathic hand from objective- and patient-perceived measurements. Qual Life Res. 24(1):213-21, 2015.

Yang CJ, Hsu HY, Lu CH, Chao YL, Chiu HY, Kuo LC. Do we underestimate the influence of diabetic mononeuropathy and polyneuropathy on hand functional performance and quality of life? J Diabetes Investig. 9(1):179-85, 2018.

Stroke

Arwert HJ, Keizer S, Kromme CH, Vliet Vlieland TP, Meesters JJ. Validity of the Michigan Hand Outcomes Questionnaire in Patients With Stroke. Arch Phys Med Rehabil. 97(2):238-44, 2016.

Wu HC, Liao YC, Cheng YH, Shih PC, Tsai CM, Lin CY. The potential effect of a vibrotactile glove rehabilitation system on motor recovery in chronic post-stroke hemiparesis. Technol Health Care. epub ahead of print 09/08/17​

Other Publications

​Bindra RR. Dias JJ. Heras-Palau C. Amadio PC. Chung KC. Burke FD. Assessing outcome after hand surgery: the current state. J Hand Surg Br. 28:289-94, 2003.

Hoang-Kim A. Pegreffi F. Moroni A. Ladd A. Measuring wrist and hand function: common scales and checklists. Injury. 42(3):253-258, 2011.

​Oh Y, Drijkoningen T, Menendez ME, Claessen FM, Ring D. The influence of psychological factors on the Michigan Hand Questionnaire. Hand. 12(2):197-201, 2017.

​Shauver MJ. Chung KC. The Michigan hand outcomes questionnaire after 15 years of field trial. Plast Reconstr Surg. 131(5):779e-787e, 2013.

​Yaffe M, Goyal N, Kokmeyer D, Merrell GA. The use of an iPad to collect patient-reported functional outcome measures in hand surgery. Hand. 10(3):522-8, 2015.

Zyluk A, Piotuch B. [Use of questionnaires in outcome measurement in hand surgery] Chirurgia Narzadów Ruchu I Ortopedia Polska. 74(4):193-201, 2009.

For a complete list of publications please click here.

Overview

The Brief MHQ (bMHQ) contains 12 items with responses on a 1 through 5 Likert scale regarding several aspects of hand function. It is designed for clinical, rather than research, use.  The 12 items are totaled and then normalized to yield a summary score on a scale of 0-100. Higher scores indicate better overall functioning and satisfaction. Respondents must answer every question in order to calculate the brief MHQ summary score. The bMHQ does not distinguish between hands. The bilateral bMHQ does distinguish between hands. Scoring is the same for both surveys. The bMHQ will provide 1 summary score; the bilateral bMHQ will provide 2 scores that cannot be combined.

Reverse Coding

Higher scores indicate better functioning. Therefore, the following items must be reversed before totaling to create the summary score: 

1. Overall, how well did your hand(s) work during the past week?
2. How was the sensation (feeling) in your hand(s) during the past week?
3. How difficult was it for you to hold a frying pan during the last week?
4. How difficult was it for you to button a shirt or blouse during the past week?
5. Describe the pain in your hand(s)/wrist(s) in the past week?
6. I am satisfied with the look of my hand(s).
7. In the past week, how satisfied are you with the motion of your fingers?
8. In the past week, how satisfied are you with the motion of your wrist?
    

For these items, the responses must be reversed in the following way: 
1=5, 2=4, 4=2, 5=1

Scoring

Raw score range: 
 Minimum score (poorest functioning) = 1
 Maximum score (ideal functioning) = 5

The 12 raw scores (in the bilateral survey items 5, 6, and 7 are included in both the right hand and left hand total) are then added to give a maximum score of 60 and a minimum score of 12.

To translate the raw score into a 0-100 range the score must be normalized. The raw score is averaged across the number of items (range 1-5). After averaging the items, the average score is then normalized to generate a score that is scaled from 0 (poorest function) to 100 (ideal function).

Normalization = 100 x (brief MHQ raw score – 1)/4

For example:

​A raw score of 60 yields an averaged score of 5.
(5-1)/4 x 100 = 100

A raw score of 36 yields an averaged score of 3.
(3-1)/4 x 100 = 50

Please contact us if you would like us to send you one of the translated questionnaires.

The MHQ is translated using a team of translators fluent in both English and the desired language. The translation process consists of the following components:

• ​Forward translation: Two translators independently translate the MHQ from English to the desired language. The translators then meet to evaluate both translations and arrive at a consensus version.
• Backward translation: Two other translators independently translate the new version of the MHQ into English. The backward translation version is compared with the original English version. All 4 translators then meet to discuss and resolve any discrepancies. [1]

Official MHQ translations:​

• Arabic MHQ [19]
  • Khaja AF, Al-Roudhan M, Hanna SS, Boshahri MO, Al-Awadh M, Al-Samhan A. Cross-cultural adaptation, validation, and reliability of the Michigan Hand Outcomes Questionnaire: Arabic version. HSOA Journal of Surgery: Current Trends and Innovations. 2020;4(3):1-6. doi:10.24966/scti-7284/100037​
• Bahasa Melayu MHQ [18]
  • ​Kumar A, Harun H, Hakim A, Ganapathy SS, Arumugam M. Cross-cultural Adaptation and Validity of the Patient Rated Michigan Hand Outcome Questionnaire in Bahasa Melayu for Malaysian Patients. J Hand Surg Asian-Pac Vol. 27(04):636-642, 2022.
• Chinese MHQ (simple and traditional) [2]
• Dutch MHQ [3]
  • van der Giesen FJ. Nelissen RG. Arendzen JH. de Jong Z. Wolterbeek R. Vliet Vlieland TP. Responsiveness of the Michigan Hand Outcomes Questionnaire--Dutch language version in patients with rheumatoid arthritis. Arch Phys Med Rehabil. 89(6):1121-6, 2008.
  • Haan EA, Terwee CB, Van Wier MF, Willigenburg NW, Van Deurzen DFP, Pisters MF, Kaat AJ, Roorda LD. Qual Life Res. 2020 Jan 1. doi: 10.1007/s11136-019-02388-2. [Epub ahead of print]
• Farsi MHQ [4]
  • Ebrahimzadeh MH, Birjandinejad A, Kachooei AR. Cross-cultural adaptation, validation, and reliability of the Michigan Hand Outcomes Questionnaire among Persian population. Hand Surg. 20(1):25-31, 2015.
• French MHQ (French and Belgian) [14]
  • ​Efanov JI, Shine JJ, Darwich R, Besner Morin C, Arsenault J, Harris PG, Danino AM, Izadpanah A. French translation and cross-cultural adaptation of the Michigan Hand Outcomes Questionnaire and the Brief Michigan Hand Outcomes Questionnaire. Hand Surg Rehabil. 37(2):86-90, 2018.
• German MHQ [5]
  • Knobloch K, Kuehn M, Papst S, Kraemer R, Vogt PM. German standardized translation of the Michigan Hand Outcomes Questionnaire for patient-related outcome measurements in Dupuytren disease. Plast Reconstr Surg. 128(1):39-40, 2011.
  • Marks M, Audige L, Herren DB, Schindele S, Nelissen RG, Vliet Vlieland TP. Measurement properties of the German Michigan Hand Outcomes Questionnaire in patients with trapeziometacarpal osteoarthritis. Arthritis C Res. 66(2):245-52, 2014.
• Japanese MHQ [6]
  • Oda T, Abe Y, Katsumi Y, Ohi H, Nakamura T, Inagaki K. Reliability and Validity of the Japanese Version of the Michigan Hand Outcomes Questionnaire: A Comparison with the DASH and SF-36 Questionnaires. J Hand Surg Asia Pac. 21(1):72-7, 2016.
• Korean MHQ [7]
  • Roh YH, Yang BK, Noh JH, Baek GH, Song CH, Gong HS. Cross-cultural adaptation and validation of the Korean version of the Michigan hand questionnaire. J Hand Surg Am. 36:1497-1503, 2011.
  • Wi SM, Gong HS, Bae KJ, Roh YH, Lee YH, Baek GH. Responsiveness of the Korean version of the Michigan Hand Outcomes Questionnaire after carpal tunnel release. Clin Orthopae Surg. 6(2):203-7, 2014.
• Polish MHQ [8]
  • Kozuej M, Trybus M, Mydłowska A, Sałapa K, Gniadek M, Banach M, Brudnicki J. The Polish version of the Michigan Hand Outcomes Questionnaire: Cross-cultural adaptation, reliability, construct validity, and measurement error. J Hand Surg Eur. 141(5):1171-81, 2018.
• Portuguese MHQ (Brazilian) [9]
  • Pinho N, Rafael A, Cardoso A, Nardi AE. Translation and cross-cultural adaptation of the Michigan Hand Outcomes Questionnaire. J Bras Psiquiatr. 60(2):99-110, 2011.
  • Meireles SM, Natour J, Batista DA, Lopes M, Skare TL. Cross-cultural adaptation and validation of the Michigan Hand Outcomes Questionnaire for Brazil. Sao Paulo Med J. 123(6):339-47, 2014.
• Spanish MHQ [10]​​
• Swedish MHQ [16]
  • ​Blomstrand J, Karlsson J, Fagevik Olsén M, Kjellby Wendt G. The Michigan Hand Outcomes Questionnaire (MHQ-Swe) in patients with distal radius fractures—cross-cultural adaptation to Swedish, validation and reliability. Journal of Orthopaedic Surgery and Research. 16(1):442, 2021.
• Turkish MHQ [11]
  • Öksüz Ç, Akel BS, Oskay D, Leblebicioğlu G, Hayran KM. Cross-cultural adaptation, validation, and reliability process of the Michigan Hand Outcomes Questionnaire in a Turkish population. J Hand Surg Am. 36:486-492, 2011.
  • Ilhanli I, Durmus D, Orekici G. Cultural adaptation of the Michigan Hand Outcomes Questionnaire in patients with Carpal Tunnel Syndrome: A Turkish version study. Chron Dis Transl Med.1:42-47, 2015.
  • Öksüz Ç, Akel BS, Aran OT, Sığırtmaç İC, Leblebicioğlu G. Do hand outcome measures reflect cultural influences? Acta Orthop Traumatol Turc. 51(4):325-30, 2017.
• Thai MHQ [15]​
  • Dhippayom JP, Trevittaya P, Cheng ASK. Occup Ther Int. 2018 Nov 18;2018:8319875. doi: 10.1155/2018/8319875. eCollection 2018.

​Official Brief MHQ translations:

• German Brief MHQ [12]
  • Knobloch K, Kraemer R, Papst S, Sorg H, Vogt PM. German version of the Brief Michigan Hand Outcomes Questionnaire: implications for early quality of life following collagenase injection for Dupuytren contracture. Plast Reconstr Surg. 129(5):886e-7e, 2012.
• Polish Brief MHQ [13]
• Welsh Brief MHQ [17]

Footnote​

1. International Quality of Life Assessment Project. Translation. Available at: http://www.iqola.org/project.aspx#translation.
2. Translated by Dr. De-Hong Tang; Section of Plastic Surgery; Department of Surgery; University of Michigan Health System; Ann Arbor, MI, USA and Dr. Keming Wang; Plastic Surgery Hospital; Chinese Academy of Medical Sciences; Peking Union Medical College; Beijing, China.
3. Translated by Rosali Huismans and Hans Sluiter; St. Antonius Ziekenhuis, Nieuwegein; The Netherlands.
4. Translated by Layeghi F, Rassafiani M, Farzad M, and Dashab F; Department of Basic Science and Department of Occupational Therapy; The University of Social Welfare and Rehabilitation Sciences; Tehran, Iran.
5. Translated by Karsten Knobloch, MD, PhD, FACS, Marie Kuehn, Stephan Papst, MD, Robert Kraemer, MD, and Peter M. Vogt, MD, PhD; Plastic, Hand and Reconstructive Surgery; Hannover Medical School; Hannover, Germany.
6. Translated by Takashi Oda, MD, PhD; Director; Department of Orthopedic Surgery; Hokkaido Saiseikai Otaru Hospital; and Yuri Fukazawa, Michael R. Rudowski and Heather C. Littlefield; Department of Asian Languages and Culture; College of Literature, Sciences, and the Arts; University of Michigan; Ann Arbor, MI, USA.
7. Translated by Dr. Hyunsik Gong and Younghak Roh;  Seoul National University Hospital; Seoul, South Korea.
8. Translated by Mateusz Koziej, Marek Trybus, Anna Mydłowska, Maksymilian Gniadek, and Marcin Bednarek; 2nd Department of General Surgery; Jagiellonian University Medical College; Kopernika 50, 31-501 Kraków
9. Translated by Meireles SM, Natour J, Batista DA, Lopes M, Skare TL. Translation, cultural adaptation and reproducibility of the Michigan Hand Outcomes Questionnaire (MHQ) for Brazil. Annals of the Rheumatic Diseases 2013; 72 suppl 3:576.
10. Translated by Dr. Francisco del Piñal; Instituto de Cirugía Plástica de la Mano; Santander, Spain.
11. Translated by Dr. Cigdem Oksuz; Health Science Faculty; Physical Therapy and Rehabilitation Department; Hacettepe University; Ankara, Turkey.
12. Translated by Knobloch K, Krämer R, Papst S, Sorg H, Vogt PM; Plastic, Hand and Reconstructive Surgery; Hannover Medical School; Hannover, Germany.
13. Translated by Sylwia Chwiesko-Minarowska, Marzena Pijanowska, Monika Jablonska, and Anna Kurliszyn-Moskal; Department of Rehabilitation; Medical University of Bialystok; Bialystok, Poland and Lukasz Minarowski; Department of Lung Diseases and Tuberculosis; Medical University of Bialystok; Bialystok, Poland.
14. Translated by AbbVie Pharmaceuticals
15. Translated by Assistant Professors Dr. Jananya P. Dhippayom (e-mail: [email protected]) and Dr. Piyawat Trevittaya (e-mail: [email protected]); Department of Occupational Therapy; Faculty of Associated Medical Sciences; Chiang Mai University; Chiangmai, Thailand 50200
16. Translated by Blomstrand J, Karlsson J, Fagevik Olsén M, Kjellby Wendt G; Department of Occupational Therapy and Physiotherapy; Sahlgrenska University Hospital; Mölndal, Sweden.
17. Translated by Kathleen Withers, Principal Evaluation Scientist/Honorary Research Associate (Cardiff University); HOPE Wales; CEDAR Healthcare Technology Research Centre; Cardiff Medicentre; Heath Park, CARDIFF.
18. Translated by Abilash Kumar, Hezery Harun, Ashraf Hakim, Shubash Shander Ganapathy, and Manohr Arumugam; Department of Orthopaedic Surgery; University Putra Malaysia; Serdang, Selangor, Malaysia.
19. Translated by Aliaa Khaja, Meshari Al-Roudhan, Sager Hanna, Mohammad Boshahri, Mohammad Al-Awadh, Awdhah Al-Samhan; Department of Trauma and orthopedics, Al Razi Orthopedic Hospital, Kuwait

Yes (although it is free for academic institutions/non-profits). Please complete the appropriate license via the University of Michigan Office of Tech Transfer.

The MHQ has already been used for a variety of conditions, and is appropriate for any condition or injury of the hand(s) and/or wrist(s).

The MHQ has been validated for use in adults over the age of 18. At this time, the MHQ has not been validated for use in children; studies are underway to do this.

Yes, please see the following publication: Nolte MT, Shauver MJ, Chung KC. Normative values of the Michigan Hand Outcomes Questionnaire for patients with and without hand conditions. Plast Reconstr Surg 2017;140(3):425-433.​

You can use these two citations below for the MHQ:​

1. Chung KC. Hamill JB. Walters MR. Hayward RA. The Michigan Hand Outcomes Questionnaire (MHQ): assessment of responsiveness to clinical change. Annals of Plastic Surgery. 42(6):619-22, 1999.
2. Chung KC. Pillsbury MS. Walters MR. Hayward RA. Reliability and validity testing of the Michigan Hand Outcomes Questionnaire. Journal of Hand Surgery - American Volume. 23(4):575-87, 1998.

When scoring the MHQ, if 50% or more of the responses in a scale are missing, then that particular scale cannot be scored. For scales with less than 50% missing, the missing responses are replaced with the average value of all complete responses in that scale. Please see "Scoring the MHQ" for detailed instructions.

If you have an old version of the MHQ, it likely has demographic questions at the end. These questions can be altered to meet your needs. You may also add any additional demographic or injury-related questions you require. These questions are not included in any scoring mechanism however.

We recommend that you use the whole survey. Individual questions from the MHQ cannot be scored, and therefore have little value. But, we understand that there are special circumstances in which it is not feasible or appropriate to measure all the scales. In these cases the scales should be kept intact. For example, if an investigator is only interested in the Aesthetics scale, he/she must use all 8 questions (4 for each hand) in the Aesthetics scale for the score to have any meaningful value.