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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 4, 524-527.
doi: 10.1302/0301-620X.88B4.17223  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Does the disabilities of the arm, shoulder and hand (DASH) scoring system only measure disability due to injuries to the upper limb?

A. S. Dowrick, MAppSc, PhD, Scholar1; B. J. Gabbe, MAppSc, PhD, Research Fellow1; O. D. Williamson, MBBS, FRACS, Orthopaedic Surgeon1; and P. A. Cameron, MD, FACEM, Professor and Head of Pre-Hospital, Emergency and Trauma Group1

1 Department of Epidemiology and Preventive Medicine, Monash University, Central and Eastern Clinical School, Alfred Hospital, Commercial Road, Melbourne, Victoria 3004, Australia.

Correspondence should be sent to Professor P. A. Cameron; e-mail: Peter.Cameron{at}med.monash.edu.au

Although the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was designed, and has been validated, as a measure of disability in patients with disorders of the upper limb, the influence of those of the lower limb on disability as measured by the DASH score has not been assessed. The aim of this study was to investigate whether it exclusively measures disability associated with injuries to the upper limb. The Short Musculoskeletal Functional Assessment, a general musculoskeletal assessment instrument, was also completed by participants. Disability was compared in 206 participants, 84 with an injury to the upper limb, 73 with injury to the lower limb and 49 controls.

We found that the DASH score also measured disability in patients with injuries to the lower limb. Care must therefore be taken when attributing disability measured by the DASH score to injuries of the upper limb when problems are also present in the lower limb. Its inability to discriminate clearly between disability due to problems at these separate sites must be taken into account when using this instrument in clinical practice or research.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General