Article
The usefulness of Disability of the Arm, Shoulder and Hand (DASH) in patients with shoulder disorders
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Published: | February 6, 2020 |
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Objectives/Interrogation: Disability of the Arm, Shoulder and Hand (DASH) is one of the most popular patients' oriented functional measures in the upper extremity and is widely used for patients with hand, finger, and elbow disorders, however, has rarely been used in patients with shoulder disorders. The purpose of this study was to assess the usefulness of DASH for patients with shoulder disorders.
Methods: Shoulder function of patients who underwent arthroscopic surgery for rotator cuff tear (RCT, n=58) and Bankart lesion (BL, n=112) were evaluated using DASH preoperatively and 3, 6, 9, 12, 18, 24 month postoperatively. Simultaneously, we evaluated Japan Orthopaedic Association Shoulder Functional Score (JOA score: Surgeons' oriented outcome measure), and isokinetic shoulder rotatory muscle strength. Isokinetic muscle strength was measured using Biodex System 3 (Biodex, NY) at 60 deg/sec condition, and contralateral peak torque ratio (injured side peak torque was divided by contra-lateral side peak torque). We assessed correlations between DASH, JOA score, and muscle strength.
Results and Conclusions: Preoperative DASH was 39.8 (SD:23.2) in patients with RCT, and gradually decreased to 4.1(SD:1.6) at 24 months after surgery. On the other hand, DASH was 13.2 (SD:13.0) in patients with BL, and significantly decreased to 6.9 (SD:6.6) by 6 months after surgery, and kept in low score later than 6 months. JOA was recovered to the same transitional change in patients with RCT and BL. There was significant correlation and coefficient between DASH and JOA score (r=-0.77, p<0.01). External peak torque ratio was also recovered to the same translation, and there was significant negative correlation between DASH and external peak torque ratio (r=-0.46, p<0.01).
In conclusions, the strong correlation between DASH and JOA score supported its validity and reliability in assessing shoulder function. DASH also reflected the isokinetic shoulder rotational muscle strength, and should be widely used in evaluating QOL in shoulder disorders. DASH was a very effective measure in patients with shoulder disorders.