Individual stiffness PRO measures identified in literature review.
| Study | Instrument Concept | Stem Wording | Response Options/anchors |
|---|---|---|---|
| Rhind, et al17 | (1) Severity of MS | (1) EWU | (1) 10-cm VAS, no to very severe |
| (2) Severity of MS | (2) EWU | (2) 11-point NRS, no to very severe | |
| (3) Severity of MS (4) Duration of MS | (3) EWU (4) How long did it take for your stiffness to begin to ease after you got out of bed this morning? | (3) 5-point VS, no, mild, moderate, severe, very severe (4) Mins | |
| Hazes, et al18 | (1) Severity of MS | (1) EWU | (1) 10-cm VAS, no to very severe |
| (2) Severity of MS | (2) EWU | (2) 11-point NRS, no to very severe | |
| (3) Duration of MS | (3) How long does your MS last until it begins to improve? | (3) Mins | |
| (4) Duration of MS | (4) How long does your MS last until maximum improvement occurs? | (4) Mins | |
| (5) Duration of MS | (5) Mins | ||
| (5) How long does it take you to get going properly? | |||
| Hazes, et al19 | (1) Duration of MS | (1) Waking to first improvement | (1) Mins |
| (2) Duration of MS | (2) Getting up to first improvement | (2) Mins | |
| (3) Duration of MS | (3) Waking to maximum improvement | (3) Mins | |
| (4) Duration of MS | (4) Getting up to maximum improvement | (4) Mins | |
| (5) Duration of MS | (5) Waking to complete disappearance | (5) Mins | |
| (6) Duration of MS | (6) Getting up to complete disappearance | (6) Mins | |
| Ward20 | (1) Duration of MS | (1) EWU | (1) Mins |
| Buchbinder, et al21 | (1) Duration of MS | (1) Time from awakening, EWU | (1) Mins, as time from awakening |
| Borstlap, et al22 | (1) No mention of severity or duration | (1) EWU | (1) 10-cm VAS, anchors unclear |
| Vliet Vlieland, et al23 | (1) Severity of MS | (1) EWU | |
| (2) Duration of MS | (2) How long does your morning stiffness last from waking until maximum improvement occurs? | (1) 10-cm VAS, none to very severe | |
| (2) Mins, cutoff at 240 | |||
| Houssien, et al24 | (1) Duration of EMS | (1) EWU | (1) Mins |
| Wolfe25 | (1) Severity of MS | (1) How severe has your stiffness been after you first woke up in the morning? | (1) 100-mm VAS, none to extreme |
| (2) Severity after immobility | (2) 100-mm VAS, none to extreme | ||
| (2) How severe has your stiffness been after sitting or lying down or while resting later in the day? | |||
| Fransen, et al26 | (1) Duration of MS | (1) Were your joints stiff when you woke up today? If yes, how long did this extra stiffness last? | (1) 0 min, < 30 mins, 30 min to 1 h, 1–2 h, 2–4 h, > 4 h < all day, all day |
| Sarzi-Puttini, et al27 | (1) Duration of MS | (1) EWU | (1) Mins on a VAS? Anchors unclear |
| Leeb, et al28 | (1) Daily MS severity | (1) EWU | (1) 100-mm VAS, no to unbearable |
| (2) Starting stiffness after a time of rest | (2) Starting stiffness after a time of rest, EWU | (2) 100-mm VAS, no to unbearable | |
| (3) EWU | (3) Mins | ||
| (3) Duration of MS | |||
| Yazici, et al29 | (1) Duration of MS | (1) EWU | (1) 0 min, 1–15 mins, 16–59mins, ≥ 60 mins |
| Westhoff, et al30 | (1) Severity of MS | (1) EWU | (1) 11-point NRS, no to extremely severe |
| (2) Duration of MS | (2) EWU | (2) Mins | |
| Khan, et al31 | (1) Duration of MS | (1) From time of waking to time of max improvement | (1) 0 min, 1–30 mins, 31–60 mins, > 60 mins |
| El Miedany, et al32 | (1) Duration of MS | (1) Over the last week when you awoke in the morning, did you feel stiff? Please indicate the number of minutes, or hours until you are as limber as you will be for the day. | (1) Mins |
| Wiesinger, et al33 | (1) No mention of severity or duration | (1) EWU | (1) Anchors unclear |
| Jastrząbek, et al34 | (1) Duration of MS | (1) EWU | (1) Mins |
| Lie, et al35 | (1) Severity of MS | (1) How would you describe the overall level of morning stiffness you have had from the time you wake up? | (1) 10-cm VAS, none to very severe |
| (2) Duration of MS | (2) 10-cm VAS, 0 = 0 h to 10 = > 2 h | ||
| (2) How long does your morning stiffness last from the time you wake up? | |||
| Bykerk, et al36 | (1) Severity of MS | (1) EWU | (1) Response options unclear |
| (2) Duration of MS | (2) EWU | (2) Response options unclear | |
| (3) Stiffness severity | (3) EWU | (3) 11-point NRS, anchors unclear | |
| Hamad, et al37 | (1) Duration of MS | (1) How long does your MS last until maximum improvement occurs? | (1) Mins |
| Bartlett, et al38 | (1) Stiffness | (1) Stiffness, EWU | |
| (2) Duration of MS | (2) Were your joints stiff when you woke up today? If yes, how long did this extra stiffness last? | (1) 11-point NRS, anchors unclear | |
| (2) 0 min, < 30 mins, 30 mins to 1 h, 1–2 h, 2–4 h, > 4 h to < all day, all day | |||
| van Nies, et al39* | (1) Duration of MS | (1) Do you experience stiffness when you get up in the morning? If so, for how many minutes? | (1) Mins, < 60 or ≥ 60 and ≥ 30 or ≥ 90 |
| (2) Duration of MS | (2) Mins, < 60 or ≥ 60 and ≥ 30 or ≥ 90 | ||
| (3) Duration of MS | (2) Do you experience morning stiffness? If yes, for how long? | (3) Mins, < 60 or ≥ 60 and ≥ 30 or ≥ 90 | |
| (4) Severity of MS | (3) Do you experience stiffness in your joints in the morning? And if so, how long does this stiffness endure? | (4) 100-mm VAS, mild 0–33, moderate 34–67, severe 68–100 | |
| (4) EWU | |||
| Ward, et al40 | (1) Severity of MS | (1) EWU | (1) 100-mm VAS, none to very severe |
| (2) MS transition | (2) Since the start of the study, my stiffness in the morning has… | (2) 3-point VS, improved, stayed the same, worsened | |
| (3) MS transition importance | (3) MS transition importance, EWU | (3) 7-point VS, hardly important at all to extremely important | |
| Ward, et al41 | (1) Severity of MS | (1) EWU | (1) 100-mm VAS, none to severe |
| (2) Duration of MS | (2) How long does your MS last until maximum improvement occurs? | (2) Mins |
↵* Different cohorts used different questions. PRO: patient-reported outcome; MS: morning stiffness; EMS: early morning stiffness; EWU: exact wording unclear; VAS: visual analog scale; NRS: numerical rating scale; VS: verbal scale.