The Relative Responsiveness and Construct Validity of the Spanish Version of the Dash Instrument for Outcomes Assessment in Open Carpal Tunnel Release

Abstract

The objective of this study was to evaluate the responsiveness and construct validity of the Spanish version of the DASH as outcome measure for carpal tunnel surgery. The study population was 42 patients with the diagnosis of carpal tunnel syndrome (CTS) based on clinical and electrophysiological criteria. The clinical design was a classic Cohort study with measures the day before and 12 weeks after open carpal tunnel release. The Spanish version of the DASH was compared to the physical exam measures as dexterity time, grip and pinch strength, range of motion of the wrist (ROM) and two-point discrimination (2PPD). The responsiveness was evaluated based on the effect size (ES) and the standardised response means (SRM). The Spanish version of the CTS questionnaire (CTQ) and the Spanish version of the 36-item short-form health survey (SF-36) were self-administered to the same study population and followed the same clinical design. The hypothesis that the DASH instrument should present a responsiveness level higher than the SF-36 and lower than the CTQ was established to demonstrate the construct validity. The DASH instrument showed an ES of 0.68 and an SRM of 1.00. Responsiveness of traditional physical exam measures were lower, running from 0.35 (SRM) for dexterity time to 0.00 (ES) for key pinch strength. The SF-36 presented a responsiveness level (range from 0.07 to 0.14) lower that the DASH. The CTQ showed the highest level of responsiveness (ES = 1.41 and 0.7) (SRM = 1.75 and 0.51). In conclusion, The DASH instrument is more sensitive in detecting clinical change than the physical exam measures for use in clinical outcome studies of CTS done at 12 weeks after surgery. The Spanish DASH showed a responsiveness lower than the CTQ and higher than the SF-36 as a proof of a good construct validity.

Responsiveness of the Korean Version of the Disabilities of the Arm, Shoulder and Hand Questionnaire (K-DASH) after Carpal Tunnel Release

“…Studies have found that the Japanese version of DASH had a small degree of responsiveness and the Spanish version of DASH had a moderate degree of responsiveness in terms of the SRM and ES for the patients with CTS (Table 3). 21,22) Compared with these studies, the K-DASH was found to have a larger degree of responsiveness (SRM, 0.8; ES, 0.8) for Korean patients with CTS. The reason that the K-DASH had a larger responsiveness is not clear.…”

Short-Term Outcomes after Median Nerve Release for Carpal Tunnel Syndrome

“…The validation studies into Spanish show great validity in their construction with a great sensibility to change in pain [26] . The study of Gay et al even advised to have the DASH performed as a single test, in a study at 6 and 12 weeks of evaluation [23] .…”

Biología del transporte axonal y síndrome de doble compresión

“…Todas las versiones españolas de los instrumentos de medición de resultados empleados presentaban un nivel satisfactorio de confiabilidad (consistencia interna y reproductibilidad), así como validez para medir resultados en una población de pacientes afectos de neuropatía compresiva. [52][53][54] Análisis Estadístico. Valoración de resultados.…”

“…Así, existe una mejoría de los síntomas en relación a la compresión distal en una magnitud muy similar a la reportada en la población de STC por otros autores. [54][55][56][57][58][59] En cambio, la magnitud de la mejoría observada con el instrumento DASH fue menor a la que se observa en aquellos pacientes afectos de STC. 49,56 Ello se debe a que el instrumento DASH es específico de MMSS y diseñado para medir discapacidad de MMSS; y por tanto, es capaz de detectar detrimentos de la salud que son ocasionados por la compresión proximal.…”