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Disabilities of the Arm, Shoulder and Hand (DASH) 20 Years Old: The Little Tool that Grew
Carol A. Kennedy, BScPT, MSc1; Dorcas E. Beaton, PhD2
1Institute for Work & Health, Toronto, ON, Canada; 2University of Toronto, Toronto, ON, Canada

Introduction: The DASH (Disabilities of the Arm, Shoulder and Hand) Outcome Measure is a well-recognized instrument for measuring upper-limb function and symptoms. The self-completed questionnaire was designed to measure the impact on function (at the level of disability) of a wide variety of musculoskeletal conditions and injuries affecting the upper limb. Understanding how the DASH Outcome Measure Users are utilizing the outcome measure may provide opportunities to identify gaps in knowledge and provide direction for future research and application. The purpose of this study was 1) To describe how the DASH Outcome Measure was being used in clinical practice and/or research, and 2) To determine the level of endorsement of DASH items by DASH users.

Materials & Methods: A cross-sectional survey was administered to registered DASH Outcome Measure users. The survey inquired about the nature of users' practice, the patients for which the DASH and QuickDASH were being used, users' engagement in research activities using the DASH and QuickDASH, and users' endorsement of DASH items.

Results: 172 DASH users completed the survey. Respondents were mostly from the United States (52%) followed by Europe (23.6%) and Canada (9.5%). Most respondents were treating clinicians (77%), and the remaining being researchers/educators (23%). One or both of the DASH and/or QuickDASH were consistently (89.5%) being used. 62.3% were using one or both of the DASH Optional Modules. About 90% of users were using the DASH and QuickDASH in adults (21-65 years). However, a majority (72.9%) was also using the instruments in patients over the age of 65, and a smaller proportion (13.9%) in patients under the age of 15. The DASH and QuickDASH were being used across the entire upper extremity (70-82%), including the neck 10% of the time. The measures are mostly (66.9-73.7%) being used as designed for primary musculoskeletal disorders (including joint-, tendon-, and nerve-related disorders), with some users applying the instrument for other non-musculoskeletal specific conditions (2.5-16.6%). All DASH items had at least 10% endorsement, suggesting that we need information on all 30-items.

Conclusions: This survey indicates that DASH Outcome Measure has grown beyond its intended use. The DASH and QuickDASH are being used outside of the body regions, types of disorders and age groups for which it was originally developed. Future measurement research on the DASH Outcome Measure should target the populations that have not yet been studied.

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