Article

The Disabilities of Arm, Shoulder and Hand (DASH) questionnaire is a
patient reported outcome measure for evaluating upper limb function in people
with musculoskeletal conditions. While the DASH has good psychometric properties
when used with people with musculoskeletal conditions, it has not been tested
with adults after stroke. METHODS: Data for n = 61 adults following stroke (aged
32-93 years, 44% male) were analyzed to test validity and reliability of the DASH
for use with a stroke population. Data included demographic and clinical
attributes, DASH scores (baseline and four weeks later) and Patient Rated Wrist
Evaluation (PRWE) measures. RESULTS: Internal consistency was good (Cronbach
alpha 0.92, SEM 6.65). Factor analysis and Rasch modeling suggested that the
questionnaire comprised three subscales: pain, impact and function. Concurrent
validity between the DASH and PRWE (Spearman's Rho rs = 0.41) was moderate. The
scale was perceived by clinicians to be useful, quick and simple to administer.
The DASH had low four-week test-retest reliability (ICC 0.56 [95% Cl 0.05-0.79]).
CONCLUSIONS: The DASH is considered to have acceptable validity when used with
adults following stroke. Test-retest reliability was low but further research is
needed to establish whether this is a result of condition-related change or the
stability of the measure. Implications for Rehabilitation The DASH questionnaire
examines upper limb function in task performance and appears to be a useful tool,
which is simple to administer in the clinical setting with adults following
stroke. Upper limb function post stroke can be meaningfully assessed using the
DASH as it has good internal consistency and moderate concurrent validity. Rasch
analysis and factor analysis suggests that the tool appears to consist of three
subscales: pain, impact and function. The total score of the DASH may be less
meaningful than the totals of these subscales. The test-retest reliability of the
DASH requires further research; over a four-week period DASH stability was poor
in a group of people with moderate to severe upper limb impairment.

Langue : ANGLAIS