[Reliability and responsiveness of the German version of the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH)].
BACKGROUND
Whilst there are some studies which have focussed on the validity and also others partially on the reliability of the German version of the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH), studies regarding test-retest reliability and responsiveness do not exist. The purpose of this study was to analyse these two meaningful properties of the officially approved German version of the DASH.


METHODS
Of 101 consecutive patients with distal radius fractures, 72 were followed prospectively at three time intervals. To evaluate the reliability, internal consistency (Cronbach's alpha) and correlation between the DASH points from the 12- and 13-week examinations (Spearman's correlation coefficient and intra-class coefficient) were calculated. Responsiveness was assessed using the parameters change score, standardised effect size and standardised response mean. These values were compared with the same values obtained from the traditional measures of grip strength and range of motion.


RESULTS
Internal consistency and test-retest reliability of the DASH were excellent (Cronbach's alpha >0.95, Spearman's correlation coefficient r=0.912, ICC=0.945). Responsiveness of the DASH was moderate (change score=8.93, SRM=0.55, SES=0.41). Responsiveness of the ROM deficit and grip strength were larger than that for data from the DASH.


CONCLUSIONS
The German DASH is a reliable and responsive measure. It can detect changes in disabilities over time in patients with distal radius fractures. Traditional impairment measures reflect important functional aspects and should be included in clinical outcome evaluation.
Westphal
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Sektion Unfallchirurgie und Orthopädie, Klinik für Chirurgie, Klinikum Süd, Südring 81, 18059 Rostock. thomas.westphal@kliniksued-rostock.de
D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D008432:Mathematical Computing; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D011885:Radius Fractures / Q000601:surgery*; D016059:Range of Motion, Articular; D012680:Sensitivity and Specificity; D012984:Software; D011795:Surveys and Questionnaires; D014954:Wrist Injuries / Q000601:surgery*