CHAPTER 77: QUICKDASH (DISABILITY OF THE ARM, SHOULDER AND HAND) OUTCOME MEASURE

Description

The QuickDASH (Disability of the Arm, Shoulder and Hand) is a self-report questionnaire that assesses a person’s perceived level of incapacity pertaining to disability of the arm, shoulder, and hand and is based on the 30-item DASH instrument, where each item on the QuickDASH was retained relative to key concepts of upper-limb functioning as well as the selection of the highest ranked items from the original according to their psychometric properties (Kennedy et al., 2013). The assessment explores the ability to perform certain activities as well as symptoms associated with arm, shoulder, and hand impairment and includes such items as (1) opening a tight or new jar; (2) doing heavy household chores (i.e. wash walls, floors); (3) carrying a shopping bag or briefcase; and (4) the presence or absence of tingling (pins and needles) in arm, shoulder, or hand, as well as interference with work or other activities due to injury. Each item of the QuickDASH is rated along a 5-point scale (1 to 5) of various responses (i.e., none to extreme or no difficulty to unable) and like the original assessment has 2 optional modules pertaining to work and sports/performing arts that have 4 items each. The assessment can be completed in less than 5 minutes with higher scores suggestive of greater impairment.

Psychometrics

During development, using data derived from 407 and 200 subjects with various upper extremity limb impairments, test-retest reliabilities were significant at r = 0.94, while convergent construct validity ranged from 0.70 to 0.80 for the various domains, and correlation with change ranged from 0.35 to 0.39 (Beaton, Wright, & Katz, 2005). Whalley and Adams (2009) found that when used in an outpatient occupational therapy clinic, QuickDASH showed responsiveness to change as scores were 50.43 (mean) at baseline and 32.13 at discharge. Results of the QuickDASH using a cohort of 255 subjects before and after a physical therapy program determined that the minimum detectable change at the 90% confidence level was determined to be 12.85 points (Franchignoni et al., 2014). A study of 101 persons presenting to physical therapy found test-retest reliability to be r = 0.90 with mean scores at baseline of 37.2 and 30.4 at follow up, whereas the correlation coefficients between change in scores with the Numeric Pain Rating Scale and the Global Rating of Change scale were 0.45 and 0.26, respectively (Mintken, Glynn, & Cleland, 2009). A study by Polson, Reid, McNair, and Larmer (2010) of 35 subjects recruited from private physiotherapy practice found mean scores for the QuickDASH at baseline were 37.7, which decreased to 18.5 at discharge or 6 weeks post-baseline, suggesting that the QuickDASH is a responsive questionnaire. A study of persons with Deputryn’s syndrome found a statistically significant correlation between the preoperative QuickDASH score and the mean total range of movement at –0.33 (Budd, Larson, Chojnowski, & Shepstone, 2011).

Advantages

There is a good amount of research in support of the QuickDASH for use in clinical practice. The assessment is free to use in certain populations and administration time is less than 5 minutes. Based on the 30-item DASH, it retains only the strongest statistical items. The Institute for Work & Health maintains a website devoted to the QuickDASH measure where information can be found and downloaded. Access to a free online form as well as a score calculation service is also available.

Disadvantages

The QuickDASH is primarily composed of activity items that measure physical disability leaving low impact, non-activity items out. Thus it could be argued that the 11-item short form may not cover all relevant domains associated with arm, shoulder, and hand injury (Gummesson, Ward, & Atroshi, 2006).

Administration

The QuickDASH has clearly outlined instructions as well as scoring interpretations available. During assessment the client is asked to consider and rate each item using various self-perceived rating scales from 1 to 5 relative to issues associated with disability of the arm, shoulder, and hand, with particular regard for function and feeling. An optional sports/performing arts and work section can also be completed. Scoring employs the following algorithm:

*n=number of response

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