[Spanish version of the DASH questionnaire. Cross-cultural adaptation, reliability, validity and responsiveness].
OBJECTIVE
The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is a specific outcome instrument developed to measure upper-extremity disability and symptoms. The aim of this work is to develop a Spanish version of the DASH questionnaire and to analyze its reliability, validity and responsiveness.


METHODS
We performed cross-cultural adaptation of the DASH to Spanish, using a process that included double forward and backward translations, expert review and field-testing. The Spanish version's reliability, content, construct and criterion validity and responsiveness were then evaluated in 98 patients with upper-extremity conditions that completed the DASH and SF-36 generic health questionnaire before and after medical rehabilitation treatment.


RESULTS
We obtained a Spanish DASH version (DASHe) linguistically and conceptually equivalent to the original version. Internal consistency of the DASHe was high (Cronbach alpha = 0.96), test-retest reliability was excellent (r = 0.96) and the floor and ceiling effects were negligible. Construct and criteria validity was shown by a positive association of DASHe scores with worse condition, and a significant correlation with the SF-36 scores, stronger with the SF-36 pain dimension. Responsiveness was excellent (effect size and standardized response means higher than 0.80).


CONCLUSIONS
The DASHe is a reliable, valid and responsive instrument that can provide a standardized measure in Spanish patients with upper-extremity musculoskeletal conditions.
Hervás
María Teresa
MT
Servicio de Rehabilitación, Hospital Universitario Dr. Peset, Valencia, Spain.
Navarro Collado
María José
MJ
Peiró
Salvador
S
Rodrigo Pérez
José Luis
JL
López Matéu
Pedro
P
Martínez Tello
Isabel
I
D000328:Adult; D000368:Aged; D003431:Cross-Cultural Comparison; D004185:Disability Evaluation; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000534:rehabilitation*; D015203:Reproducibility of Results; D013030:Spain; D011795:Surveys and Questionnaires; D014175:Translating; D034941:Upper Extremity