Reliability, validity and responsiveness of the French version of the questionnaire Quick Disability of the Arm, Shoulder and Hand in shoulder disorders

Abstract

We assessed the reliability, validity and responsiveness of the French short version of the scale Disability of the Arm, Shoulder and Hand-Disability/Symptom (F-QuickDASH-D/S) in patients with shoulder disorders. We extracted QuickDASH item responses from the responses to the full-length DASH questionnaire completed by 153 patients. In addition to collecting demographic and clinical data, subjective assessment of activities of daily living (ADL), active range of motion (ROM), and measurement of abduction strength (strength) were recorded by use of the Constant scale. Cronbach's alpha coefficient was 0.89. The intraclass correlation coefficient was 0.94, which suggested excellent test–retest reliability. Correlation of the F-QuickDASH-D/S score with scores for F-DASH-D/S (r = 0.96), handicap (r = 0.79), ADL (r = −0.73), pain during activities (r = 0.63), strength (r = −0.58), pain at rest (r = 0.57) and ROM (r = −0.51) indicated good construct validity. Factor analysis identified 2 factors accounting for 59.1% of the variance. The responsiveness of F-QuickDASH-D/S was excellent, with standardized response mean and effect size values of 1.09 and 1.23, respectively. The F-QuickDASH-D/S has good reliability, construct validity and responsiveness. The strong correlation of its score with the full-length DASH-D/S scale score suggests that the QuickDASH-D/S could be the preferred scale because it is easier to use.

Introduction

Symptomatic shoulder disorders constitute the third most common musculoskeletal reason, after back and neck pain, for consultation in medical practice (Rekola et al., 1993, Linsell et al., 2006, Feleus et al., 2008). Patient's subjective perception of their disease status is decisive for both diagnostic work-up and subsequent therapeutic management. In addition, patient-reported outcome measures have become an important part of the assessment used in clinical studies. Numerous shoulder outcome-measure instruments are available (Fayad et al., 2005). The Disability of the Arm, Shoulder, and Hand scale (DASH) (Hudak et al., 1996) is among the best-rated self-administered questionnaires for their clinimetric properties (Bot et al., 2004, Gabel et al., 2006). From the original 30-item DASH questionnaire, a shorter version, of 11 items, the QuickDASH, was recently developed (Beaton et al., 2005). The psychometric properties of the QuickDASH are similar to those of the original questionnaire, and the QuickDASH may be preferred because of the reduced time for responding as well as less administrative burden. Furthermore, the QuickDASH has been selected by the American Medical Association' Guides to the Evaluation of Permanent Impairment for the functional assessment measure of the upper extremity (Matheson et al., 2006).

Cross-cultural adaptation of validated outcome instruments has been advocated to facilitate their use in international multicenter clinical trials (Ware et al., 1995), which would also reduce the need for developing new instruments with the same purpose. The full-length version of the DASH has been validated or translated in several languages (Atroshi et al., 2000, Dubert et al., 2001, Offenbaecher et al., 2002, Padua et al., 2003, Lee et al., 2005). The references are some examples only, because many more language versions exist, and the list here is not exhaustive. However, to date for the QuickDASH only English, Sweden and Japanese versions have been validated (Beaton et al., 2005, Gummesson et al., 2006, Imaeda et al., 2006).

We aimed to assess the reliability, validity and responsiveness of the French version of the Disability/Symptom scale of the QuickDASH (F-QuickDASH-D/S) in patients with common shoulder disorders.