Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2014

Open Access 01-12-2014 | Research article

Reliability and validity of the Norwegian version of the Disabilities of the Arm, Shoulder and Hand questionnaire in patients with shoulder impingement syndrome

Authors: Benjamin Haldorsen, Ida Svege, Yngve Roe, Astrid Bergland

Published in: BMC Musculoskeletal Disorders | Issue 1/2014

Login to get access

Abstract

Background

Patient-rated outcome measures (PROMs) are an important part of clinical decision-making in rehabilitation of patients with shoulder pain. The Disabilities of Arm, Shoulder and Hand (DASH) questionnaire was designed to measure physical disability and symptoms in patients with musculoskeletal disorders of the upper extremity and is one the most commonly used outcome measures for patients with shoulder pain. The purpose of this study was to investigate the reliability and validity of the Norwegian version of the DASH in patients with shoulder impingement syndrome.

Methods

Sixty-three patients diagnosed with shoulder impingement syndrome at an orthopaedic outpatient clinic were included in the study. Internal consistency of the DASH was evaluated by the Cronbach’s alpha and item-to-total correlations. Test-retest reliability was analyzed by the intraclass correlation coefficient (ICC) and limits of agreement (LoA) according to the Bland Altman method. Standard error of measurement (SEM) and minimally detectable change (MDC) were calculated for the total DASH score. Construct validity was evaluated by testing six a priori hypotheses for the Pearson’s correlation coefficient between the DASH and the Shoulder Pain and Disability Index (SPADI), the 36-item Short Form Health Survey (SF-36) and a Numeric Pain Rating Scale (NPRS).

Results

Reliability: Cronbach’s alpha of the DASH was 0.93 and item-to-total correlations ranged from 0.36 to 0.81. ICC was 0.89. The 95 percent LoA was calculated to be between -11.9 and 14.1. SEM was 4.7 and MDC 13.1. Construct validity: Eighty-three percent of the a priori hypotheses of correlation were confirmed. The DASH showed a high positive correlation of 0.75 with the SPADI, a negative moderate correlation of -0.48 to -0.62 with physical functioning, bodily pain and physical component summary of the SF-36 and a moderate positive correlation of 0.58 with the NPRS. DASH correlated higher with the physical component summary than with the mental component summary of the SF-36.

Conclusions

The Norwegian version of the DASH is a reliable and valid outcome measure for patients with shoulder impingement syndrome.
Appendix
Available only for authorised users
Literature
1.
Bot SDM, Terwee CB, van der Windt DAWN, Bouter LM, Dekker J, de Vet HCW: Clinimetric evaluation of shoulder disability questionnaires: a systematic review of the literature. Ann Rheum Dis. 2004, 63: 335-341. 10.1136/ard.2003.007724.CrossRefPubMedPubMedCentral
2.
Angst F, Schwyzer HK, Aeschlimann A, Simmen BR, Goldhahn J: Measures of adult shoulder function: Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and its short version (QuickDASH), Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) Society standardized shoulder assessment form, Constant (Murley) Score (CS), Simple Shoulder Test (SST), Oxford Shoulder Score (OSS), Shoulder Disability Questionnaire (SDQ), and Western Ontario Shoulder Instability Index (WOSI). Arthritis Care Res. 2011, 63 (Suppl 11): S174-S188.CrossRef
3.
Hudak PL, Amadio PC, Bombardier C, Beaton D, Cole D, Davies A, Hawker G, Katz JN, Makela M, Marx RG, Punnett L, Wright J: Development of an upper extremity outcome measure: The DASH (disabilities of the arm, shoulder and hand). Am J Ind Med. 1996, 29: 602-608. 10.1002/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-L.CrossRefPubMed
4.
Beaton DE, Davis AM, Hudak P, McConnell S: The DASH (Disabilities of the Arm, Shoulder and Hand) Outcome Measure: What do we know about it now?. Br J Hand Ther. 2001, 6: 109-118.
5.
Kennedy CA, Beaton DE, Solway S, McConnell S, Bombardier C: The DASH and QuickDASH Outcome Measure User’s Manual. 2011, Toronto, Ontario: Institute for Work & Health, 3
6.
7.
Roy JS, MacDermid JC, Woodhouse LJ: Measuring shoulder function: a systematic review of four questionnaires. Arthritis Care Res. 2009, 61: 623-632. 10.1002/art.24396.CrossRef
8.
Van der Windt DAWM, Koes BW, de Jong BA, Bouter LM: Shoulder disorders in general practice: incidence, patient characteristics, and management. Ann Rheum Dis. 1995, 54: 959-964. 10.1136/ard.54.12.959.CrossRefPubMedPubMedCentral
9.
Silva L, Andréu JL, Muñoz P, Pastrana M, Millán I, Sanz J, Barbadillo C, Fernández-Castro M: Accuracy of physical examination in subacromial impingement syndrome. Rheumatology (Oxford). 2008, 47: 679-683. 10.1093/rheumatology/ken101.CrossRef
10.
Bigliani LU, Levine WN: Current concepts review. Subacromial impingement syndrome. J Bone Joint Surg. 1997, 79: 1854-1868.PubMed
11.
Michener LA, McClure PW, Karduna AR: Anatomical and biomechanical mechanisms of subacromial impingement syndrome. Clin Biomech (Bristol, Avon). 2003, 18: 369-379. 10.1016/S0268-0033(03)00047-0.CrossRef
12.
McKenna SP, Doward LC: The translation and cultural adaptation of patient-reported outcome measures. Value Health. 2005, 8: 89-91. 10.1111/j.1524-4733.2005.08203.x.CrossRefPubMed
13.
Hawkins RJ, Kennedy JC: Impingement syndrome in athletes. Am J Sports Med. 1980, 8: 151-158. 10.1177/036354658000800302.CrossRefPubMed
14.
Finsen V: Norwegian version of the DASH questionnaire for evaluation of the arm, shoulder and hand. Tidsskr Nor Laegeforen. 2008, 128: 1070-(In Norwegian)PubMed
15.
Roach KE, Budiman-Mak E, Songsiridej N, Lertratanakul Y: Development of a shoulder pain and disability index. Arthritis Care Res. 1991, 4: 143-149. 10.1002/art.1790040403.CrossRefPubMed
16.
Tveitå EK, Ekeberg OM, Juel NG, Bautz-Holter E: Responsiveness of the shoulder pain and disability index in patients with adhesive capsulitis. BMC Musculoskelet Disord. 2008, 9: 161-10.1186/1471-2474-9-161.CrossRefPubMedPubMedCentral
17.
Ekeberg OM, Bautz-Holter E, Tveitå EK, Keller A, Juel NG, Brox JI: Agreement, reliability and validity in 3 shoulder questionnaires in patients with rotator cuff disease. BMC Musculoskelet Disord. 2008, 9: 68-10.1186/1471-2474-9-68.CrossRefPubMedPubMedCentral
18.
19.
Loge JH, Kaasa S, Hjermstad MJ, Kvien TK: Translation and performance of the Norwegian SF-36 health survey in patients with rheumatoid arthritis. I. data quality, scaling assumptions, reliability, and construct validity. J Clin Epidemiol. 1998, 51: 1069-1076. 10.1016/S0895-4356(98)00098-5.CrossRefPubMed
20.
Downie WW, Leatham PA, Rhind VM, Wright V, Branco JA, Anderson JA: Studies with pain rating scales. Ann Rheum Dis. 1978, 37: 378-381. 10.1136/ard.37.4.378.CrossRefPubMedPubMedCentral
21.
Mintken PE, Glynn P, Cleland JA: Psychometric properties of the shortened disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) and Numeric Pain Rating Scale in patients with shoulder pain. J Shoulder Elbow Surg. 2009, 18: 920-926. 10.1016/j.jse.2008.12.015.CrossRefPubMed
22.
Terwee CB, Bot SDM, de Boer MR, van der Windt DAWN, Knol DL, Dekker J, Bouter LM, de Vet HCW: Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007, 60: 34-42. 10.1016/j.jclinepi.2006.03.012.CrossRefPubMed
23.
Field AP: Discovering statistics using SPSS. 2009, Los Angeles, [Calif.]; London: SAGE
24.
Fleiss JL: The Design and Analysis of Clinical Experiments. 1986, New York: Wiley
25.
Weir JP: Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res. 2005, 19: 231-PubMed
26.
de Vet HC, Terwee CB, Ostelo RW, Beckerman H, Knol DL, Bouter LM: Minimal changes in health status questionnaires: distinction between minimally detectable change and minimally important change. Health Qual Life Outcomes. 2006, 4: 54-10.1186/1477-7525-4-54.CrossRefPubMedPubMedCentral
27.
Bland JM, Altman DG: Measuring agreement in method comparison studies. Stat Meth Med Res. 1999, 8: 135-160. 10.1191/096228099673819272.CrossRef
28.
Rowntree D: Statistics without tears: a primer for non-mathematicians. 2004, Boston: Allyn and Bacon
29.
Offenbächer M, Ewert T, Sangha O, Stucki G: Validation of a German version of the Disabilities of Arm, Shoulder and Hand questionnaire (DASH-G). Z Rheumatol. 2003, 62: 168-177. 10.1007/s00393-003-0461-7.CrossRefPubMed
30.
Atroshi I, Gummesson C, Andersson B, Dahlgren E, Johansson A: The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire. Acta Orthop Scand. 2000, 71: 613-618. 10.1080/000164700317362262.CrossRefPubMed
31.
Themistocleous GS, Goudelis G, Kyrou I, Chloros GD, Krokos A, Galanos A, Gerostathopoulos NE, Soucacos PN: Translation into Greek, cross-cultural adaptation and validation of the Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH). J Hand Ther. 2006, 19: 350-357. 10.1197/j.jht.2006.04.014.CrossRefPubMed
32.
Christie A, Hagen KB, Mowinckel P, Dagfinrud H: Methodological properties of six shoulder disability measures in patients with rheumatic diseases referred for shoulder surgery. J Shoulder Elbow Surg. 2009, 18: 89-95. 10.1016/j.jse.2008.07.008.CrossRefPubMed
33.
Hunsaker FG, Cioffi DA, Amadio PC, Wright JG, Caughlin B: The American Academy of Orthopaedic Surgeons outcomes instruments: normative values from the general population. J Bone Joint Surg. 2002, 84: 208-215.PubMed
34.
Durand MJ, Vachon B, Hong QN, Loisel P: The cross-cultural adaptation of the DASH questionnaire in Canadian French. J Hand Ther. 2005, 18: 34-39. 10.1197/j.jht.2004.10.010.CrossRefPubMed
35.
Lee EWC, Lau JSY, Chung MMH, Li APS, Lo SK: Evaluation of the Chinese version of the Disability of the Arm, Shoulder and Hand (DASH-HKPWH): cross-cultural adaptation process, internal consistency and reliability study. J Hand Ther. 2004, 17: 417-423.CrossRefPubMed
36.
Padua R, Padua L, Ceccarelli E, Romanini E, Zanoli G, Amadio PC, Campi A: Italian version of the Disability of the Arm, Shoulder and Hand (DASH) questionnaire. Cross-cultural adaptation and validation. J Hand Surg Br. 2003, 28: 179-186. 10.1016/S0266-7681(02)00303-0.CrossRefPubMed
37.
Imaeda T, Toh S, Nakao Y, Nishida J, Hirata H, Ijichi M, Kohri C, Nagano A: Validation of the Japanese Society for Surgery of the Hand version of the Disability of the Arm, Shoulder, and Hand questionnaire. J Orthop Sci. 2005, 10: 353-359. 10.1007/s00776-005-0917-5.CrossRefPubMedPubMedCentral
38.
Fayad F, Lefevre-Colau MM, Macé Y, Fermanian J, Mayoux-Benhamou A, Roren A, Rannou F, Roby-Brami A, Gautheron V, Revel M, Poiraudeau S: Validation of the French version of the Disability of the Arm, Shoulder and Hand questionnaire (F-DASH). Joint Bone Spine. 2008, 75: 195-200. 10.1016/j.jbspin.2007.04.023.CrossRefPubMed
39.
Mousavi SJ, Parnianpour M, Abedi M, Askary-Ashtiani A, Karimi A, Khorsandi A, Mehdian H: Cultural adaptation and validation of the Persian version of the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure. Clin Rehabil. 2008, 22: 749-757. 10.1177/0269215508085821.CrossRefPubMed
40.
Beaton DE, Katz JN, Fossel AH, Wright JG, Tarasuk V, Bombardier C: Measuring the whole or the parts? Validity, reliability, and responsiveness of the Disabilities of the Arm, Shoulder and Hand outcome measure in different regions of the upper extremity. J Hand Ther. 2001, 14: 128-142. 10.1016/S0894-1130(01)80043-0.CrossRefPubMed
41.
Orfale AG, Araújo PMP, Ferraz MB, Natour J: Translation into Brazilian Portuguese, cultural adaptation and evaluation of the reliability of the disabilities of the arm, shoulder and hand questionnaire. Braz J Med Biol Res. 2005, 38: 293-10.1590/S0100-879X2005000200018.CrossRefPubMed
42.
Slobogean GP, Noonan VK, O’Brien PJ: The reliability and validity of the disabilities of arm, shoulder, and hand, EuroQol-5D, health utilities index, and Short Form-6D outcome instruments in patients with proximal humeral fractures. J Shoulder Elbow Surg. 2010, 19: 342-348. 10.1016/j.jse.2009.10.021.CrossRefPubMed
43.
Marx RG, Menezes A, Horovitz L, Jones EC, Warren RF: A comparison of two time intervals for test-retest reliability of health status instruments. J Clin Epidemiol. 2003, 56: 730-735. 10.1016/S0895-4356(03)00084-2.CrossRefPubMed
44.
de Vet HCW: The minimal detectable change should not replace the minimal important difference. J Clin Epidemiol. 2010, 63: 804-805. 10.1016/j.jclinepi.2009.12.015.CrossRefPubMed
45.
Beaton DE, van Eerd D, Smith P, van der Velde G, Cullen K, Kennedy CA, Hogg-Johnson S: Minimal change is sensitive, less specific to recovery: a diagnostic testing approach to interpretability. J Clin Epidemiol. 2011, 64: 487-496. 10.1016/j.jclinepi.2010.07.012.CrossRefPubMed
46.
Roe Y, Soberg HL, Bautz-Holter E, Ostensjo S: A systematic review of measures of shoulder pain and functioning using the International classification of functioning, disability and health (ICF). BMC Musculoskelet Disord. 2013, 14: 73-10.1186/1471-2474-14-73.CrossRefPubMedPubMedCentral
47.
SooHoo NF, McDonald AP, Seiler JG, McGillivary GR: Evaluation of the construct validity of the DASH questionnaire by correlation to the SF-36. J Hand Surg Am. 2002, 27: 537-541. 10.1053/jhsu.2002.32964.CrossRefPubMed
48.
Raven EEJ, Haverkamp D, Sierevelt IN, van Montfoort DO, Pöll RG, Blankevoort L, Tak PP: Construct validity and reliability of the disability of arm, shoulder and hand questionnaire for upper extremity complaints in rheumatoid arthritis. J Rheumatol. 2008, 35: 2334-2338. 10.3899/jrheum.080067.CrossRefPubMed
49.
Lee EWC, Chung MMH, Li APS, Lo SK: Construct validity of the Chinese version of the disabilities of the arm, shoulder and hand questionnaire (DASH-HKPWH). J Hand Surg Br. 2005, 30: 29-34. 10.1016/j.jhsb.2004.09.010.CrossRefPubMed
50.
Aasheim T, Finsen V: The DASH and the QuickDASH instruments. Normative values in the general population in Norway. J Hand Surg Eur Vol. 2014, 39: 140-144. 10.1177/1753193413481302.CrossRefPubMed
51.
Jester A, Harth A, Germann G: Measuring levels of upper-extremity disability in employed adults using the DASH Questionnaire. J Hand Surg Am. 2005, 30: 1074-e1-1074.e10CrossRefPubMed
52.
Ostlie K, Franklin RJ, Skjeldal OH, Skrondal A, Magnus P: Assessing physical function in adult acquired major upper-limb amputees by combining the Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Questionnaire and clinical examination. Arch Phys Med Rehabil. 2011, 92: 1636-1645. 10.1016/j.apmr.2011.04.019.CrossRefPubMed
53.
de Witte PB, Henseler JF, Nagels J, Vliet Vlieland TP, Nelissen RG: The Western Ontario rotator cuff index in rotator cuff disease patients: a comprehensive reliability and responsiveness validation study. Am J Sports Med. 2012, 40: 1611-1619. 10.1177/0363546512446591.CrossRefPubMed
54.
Roy JS, Moffet H, McFadyen BJ: Upper limb motor strategies in persons with and without shoulder impingement syndrome across different speeds of movement. Clin Biomech (Bristol, Avon). 2008, 23: 1227-1236. 10.1016/j.clinbiomech.2008.07.009.CrossRef
55.
Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC: The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol. 2010, 63: 737-745. 10.1016/j.jclinepi.2010.02.006.CrossRefPubMed
Metadata
Title
Reliability and validity of the Norwegian version of the Disabilities of the Arm, Shoulder and Hand questionnaire in patients with shoulder impingement syndrome
Authors
Benjamin Haldorsen
Ida Svege
Yngve Roe
Astrid Bergland
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2014
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-15-78

Other articles of this Issue 1/2014

BMC Musculoskeletal Disorders 1/2014 Go to the issue

Study protocol

Preventing functional loss during immobilization after osteoporotic wrist fractures in elderly patients: a randomized clinical trial

Research article

Comparison of two-stage open versus percutaneous pedicle screw fixation in treating pyogenic spondylodiscitis

Research article

Comparative effectiveness of ultrasound and paraffin therapy in patients with carpal tunnel syndrome: a randomized trial

Research article

The effects of anterior vacuum disc on surgical outcomes of degenerative versus spondylolytic spondylolisthesis: at a minimum two-year follow-up

Research article

Development of a rapid knee cartilage damage quantification method using magnetic resonance images

Study protocol

Study protocol: non-displaced distal radial fractures in adult patients: three weeks vs. five weeks of cast immobilization: a randomized trial