The Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) can measure the impairment, activity limitations and participation restriction constructs from the International Classification of Functioning, Disability and Health (ICF).
BACKGROUND
The International Classification of Functioning, Disability and Health (ICF) model of the consequences of disease identifies three health outcomes, impairment, activity limitations and participation restrictions. However, few orthopaedic health outcome measures were developed with reference to the ICF. This study examined the ability of a valid and frequently used measure of upper limb function, namely the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH), to operationalize the ICF.


METHODS
Twenty-four judges used the method of Discriminant Content Validation to allocate the 38 items of the DASH to the theoretical definition of one or more ICF outcome. One-sample t-tests classified each item as measuring, impairment, activity limitations, participation restrictions, or a combination thereof.


RESULTS
The DASH contains items able to measure each of the three ICF outcomes with discriminant validity. The DASH contains five pure impairment items, 19 pure activity limitations items and three participation restriction items. In addition, seven items measured both activity limitations and participation restrictions.


CONCLUSIONS
The DASH can measure the three health outcomes identified by the ICF. Consequently the DASH could be used to examine the impact of trauma and subsequent interventions on each health outcome in the absence of measurement confound.
Dixon
Diane
D
Department of Psychology, University of Stirling, Stirling, Scotland, UK. diane.dixon@stir.ac.uk
Johnston
Marie
M
McQueen
Margaret
M
Court-Brown
Charles
C
D000203:Activities of Daily Living; D001132:Arm / Q000503:physiopathology*; D004185:Disability Evaluation; D006225:Hand / Q000503:physiopathology*; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008962:Models, Theoretical; D009043:Motor Activity / Q000502:physiology; D015588:Observer Variation; D017063:Outcome Assessment, Health Care / Q000145:classification*; D015203:Reproducibility of Results; D012782:Shoulder / Q000503:physiopathology*