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

Østlie, Kristin; Franklin, Rosemary Joy; Skjeldal, Ola H.; Skrondal, Anders; Magnus, Per

doi:10.1016/j.apmr.2011.04.019

Cited by 45 publications

(31 citation statements)

References 39 publications

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“…A mean score of 13 have been reported for both the general population in Norway [50] and a working population in Germany [51]. A Norwegian study of physical function in adult acquired major upper-limb amputees reported a mean DASH score of 22.7 [52]. The mean score of 29.4 (SD ± 13.8) in our study population indicated a more severe level of disability compared with these populations.…”

Section: Discussionsupporting

confidence: 48%

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

Haldorsen

Svege

Røe

et al. 2014

BMC Musculoskelet Disord

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BackgroundPatient-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.MethodsSixty-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).ResultsReliability: 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.ConclusionsThe Norwegian version of the DASH is a reliable and valid outcome measure for patients with shoulder impingement syndrome.

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Section: Discussionsupporting

confidence: 48%

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

Haldorsen

Svege

Røe

et al. 2014

BMC Musculoskelet Disord

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“…Muscle strength in the shoulder and elbow joints was consistent with previous results, which may be due to having the same measurements. Most cases did not have any movement problems in their other joints, and limited joint motion in other parts of the body was observed in the lumbar region, ankle, and foot which was in contrast with a study that reported that mobility of the neck joint was reduced bilaterally [18]. …”

Section: Discussionmentioning

confidence: 58%

“…Similarly, metacarpophalangeal, interphalangeal and thumb joints demonstrated the weakest muscle strength, which emphasized the importance of exercises to use these muscles. The results of the unilateral upper limb amputees’ survey indicated active joint motion, especially in shoulder flexion, was limited, whereas forearm rotation and muscle strength were less limited [18]. Regarding range of motion of joints, scapula retraction, shoulder abduction, elbow pronation and supination and wrist ulnar and radial deviation were the dominant limited movements due to muscle contracture.…”

Section: Discussionmentioning

confidence: 99%

A comprehensive musculoskeletal and peripheral nervous system assessment of war-related bilateral upper extremity amputees

et al. 2016

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BackgroundUpper limb amputations are one of the unpleasant war injuries that armed forces are exposed to frequently.The present study aimed to assess the musculoskeletal and peripheral nervous systems in Iraq-Iran war veterans with bilateral upper extremity amputation.MethodsThe study consisted of taking a history and clinical examinations including demographic data, presence and location of pain, level of amputation, passive and active ranges of movement of the joints across the upper and lower extremities and spine, manual palpation, neurological examination, blood circulation pulses and issues related to a prosthetic limb. In this study, 103 Iranian bilateral upper extremity amputees (206 amputations) from the Iran-Iraq war were evaluated, and a detailed questionnaire was also administered.ResultsThe most common level of amputation was the finger or wrist level (108, 52.4 %). Based on clinical examination, we found high frequencies of limited active and passive joint range of movement across the scapula, shoulder, elbow, wrist and metacarpophalangeal, interphalangeal and thumb joints. Based on muscle strength testing, we found varying degrees of weakness across the upper limbs. Musculoskeletal disorders included epicondylitis (65, 31.6 %), rotator cuff injury (24, 11.7 %), bicipital tendonitis (69, 33.5 %), shoulder drop (42, 20.4 %) and muscle atrophy (19, 9.2 %). Peripheral nerve disorders included carpal tunnel syndrome in 13 (6.3 %) and unilateral brachial plexus injury in 1 (1 %). Fifty-three (51.5 %) were diagnosed with facet joint syndrome at the level of the cervical spine (the most frequent site). Using a prosthesis was reported by 65 (63.1 %), both left and right sides. The back was the most common site of pain (71.8 %).ConclusionThe high prevalence of neuro-musculoskeletal disorders among bilateral upper extremity amputees indicates that they need regular rehabilitation care.

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“…the clinical examination). To our knowledge, there are no studies focusing on the correlation between WMSDs and the DASH score, whereas this is the case for some upper extremity pathologies other than WMSDs [55]. According to our analysis, the DASH score has the potential to replace the resource-intensive clinical examination as a screening tool.…”

Section: Discussionmentioning

confidence: 83%

Predictors for Outcomes related to upper Extremity Musculoskeletal Disorders in a healthy Working Population: a methodological Approach

Lotter¹,

Lieb²,

Molsner³

et al. 2020

Preprint

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BackgroundTo investigate the association between different clinical endpoints and the presence of upper extremity work-related musculoskeletal disorders (WMSDs) in a healthy working population. Furthermore, the influence of socio-demographic, work-related and individual predictors on different endpoints was examined.MethodsTwo self-completion questionnaires were administered to 70 workers and employees. In addition, a standardized physical examination and an industry test were performed in this cross-sectional study. Correlations between WMSDs and clinical endpoints were analysed with the Spearman method. Depending on the type of dependent endpoint, linear or logistic multivariate regression models were used to study the strength of associations with a pre-defined set of potential influencing factors.ResultsThe prevalence of WMSDs was 56% (39/70). Correlations between WMSDs and the DASH score / pain under strain (VAS) were by far the strongest ones. Independent predictors could not be identified as risk factors for WMSDs, but there was some correlation between these factors.ConclusionsThe DASH score, used in the primary analysis of the study data, remains a close candidate for best surrogate endpoint for WMSD detection. The VAS has to be examined for this role in further research. Our analysis should help to improve the methodological quality of future occupational health studies through improved standards.Trial registrationThis study was registered at ClinicalTrials.org with the identifier NCT03014128, on January 9, 2017.

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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

Cited by 45 publications

References 39 publications

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

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

A comprehensive musculoskeletal and peripheral nervous system assessment of war-related bilateral upper extremity amputees

Predictors for Outcomes related to upper Extremity Musculoskeletal Disorders in a healthy Working Population: a methodological Approach

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