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The Influence of Dominant Limb Involvement on DASH and QuickDASH
Amir Reza Kachooei, MD; Ali Moradi, MD; Stein Janssen, MD; David C. Ring, MD
Massachusetts General Hospital, Harvard University, Boston, MA

Introduction: When completing the Disabilities of the Arm Shoulder and Hand (DASH), patients rate their ability to complete specific tasks (e.g. writing) regardless of which hand they use for the task. In contrast, the Michigan Hand Outcome Questionnaire (MHOQ) takes the affected side into account. We aimed to determine whether involvement of the dominant limb affects DASH scores.

Methods: A convenience sample of 948 patients from 12 prospective studies that recorded hand dominance, affected side, diagnosis, and a DASH or QuickDASH score was used to assess the influence of involvement of the dominant limb on DASH scores. Diagnosis was categorized as traumatic and non-traumatic. Region was categorized as hand and wrist, elbow, and arm and shoulder.

Results: In bivariate analysis, involvement of the dominant limb, diagnosis, region, and sex had significant influence on DASH/QuickDASH score. In multivariable analysis, dominant hand condition, traumatic diagnosis, arm and shoulder involvement, and female sex were associated with significantly higher DASH scores (more disability), and accounted for 10% of the variability in scores.

Conclusion: Upper extremity disability as measured by the DASH is slightly, but significantly greater when the dominant limb is involved. In addition the involvement of the dominant limb, sex, region, and trauma affected DASH scores.

Table 1. Characteristics of patients with hand and upper extremity problem from 12 prospective studies (n=948)

Table 2. Multivariable Linear Regression Analysis: Predictors of DASH and QuickDASH (n=948)

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