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DASH Score

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DASH Score

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Dash Score stands for Disabilities of the Arm, Shoulder and Hand. It’s used as a measure of self-rated upper-extremity disability and symptoms.

It was first introduced by the American Academy of Orthopedic Surgeons (AAOS) in collaboration with a number of other organizations.

Users are asked to rate the difficulty of performing 30 functional tasks on a Likert type scale. Twenty-one items relate to physical function, 5 items relate to pain symptoms, and 4 items relate to emotional and social functioning.

A total dash score out of 100 is calculated, with higher scores representing more disability.

See Also: Upper Extremity Functional Index

The 30 functional tasks of DASH Score are:

The patient is asked to rate the ability to do the Following Activities in the Last week:

  1. Open a tight or new jar
  2. Write
  3. Turn a key
  4. prepare a meal
  5. Push open a heavy door
  6. Place an object on a shelf above your head
  7. Do heavy household chores (e.g., wash walls, wash floors)
  8. Garden or do yard work
  9. Make a bed
  10. Carry a shopping hag or briefcase
  11. Carry a heavy object (over 10 lbs)
  12. Change a light bulb overhead
  13. Wash or blow dry your hair
  14. Wash your hack
  15. put on a pullover sweater
  16. Use a knife to cut food
  17. Recreational activities which require little effort (e.g., card playing, knitting, etc.)
  18. Recreational activities in which you take some force or impact through your arm, shoulder or hand (e.g., golf, hammering, tennis, etc.)
  19. Recreational activities in which you move your arm freely (e.g., playing frisbee, badminton, etc.)
  20. Manage transportation needs (getting from one place to another)
  21. Sexual activities
  22. During the past week, to what extent has your arm, shoulder or hand problem interfered with your normal social activities with family, friends, neighbors or groups?
  23. During the past week, were you limited in your work or other regular daily activities as a result of your arm, shoulder or hand problem ?
  24. Arm, shoulder or hand pain
  25. Arm, shoulder or hand pain when you performed any specific activity
  26. Tingling (pins and needles) in your arm, shoulder or hand
  27. Weakness in your arm, shoulder or hand
  28. Stiffness in your arm, shoulder or hand.
  29. During the past week, how much difficulty have you had sleeping because of the pain in your arm, shoulder or hand?
  30. I feel less capable, less confident or less useful because of my arm, shoulder or hand problem.

The score is recorded as the following based on the difficulty of performing the task:

  • 1: No difficulty.
  • 2: Mild difficulty
  • 3: Moderate difficulty
  • 4: Severe difficulty
  • 5: Unable to do the task.

The DASH Score can detect and differentiate small and large changes in disability over time after surgery in patients with upper extremity musculoskeletal disorders. A 10-point difference in mean DASH score might be considered as a minimal important change.

Disabilities of the Arm, Shoulder, and Hand

Quick DASH Score

Quick DASH score is a shortened Version of Disabilities of the Arm, Shoulder, and Hand score.

Users are asked to rate questions on an 11-item questionnaire that addresses symptoms and physical function. A total score out of 100 is calculated, with higher scores representing more disability.

The 11 questions of Quick DASH Score are:

  1. Open a tight or new jar.
  2. Do heavy household chores (e.g., wash walls, floors).
  3. CarWash your back.
  4. Wash your back.
  5. Use a knife to cut food
  6. Recreational activities in which you take some force or impact through your arm, shoulder or hand (e.g., golf, hammering, tennis, etc.).
  7. During the past week, to what extent has your arm, shoulder or hand problem interfered with your normal social activities with family, friends, neighbours or groups?
  8. During the past week, were you limited in your work or other regular daily activities as a result of your arm, shoulder or hand problem?
  9. Arm, shoulder or hand pain.
  10. Tingling (pins and needles) in your arm, shoulder or hand.
  11. During the past week, how much difficulty have you had sleeping because of the pain in your arm, shoulder or hand?

Quick DASH Score DISABILITY/SYMPTOM SCORE = (sum of n responses)/n – 1 x 25, where n is equal to the number of completed responses.

Quick DASH

References

  1. Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996 Jun;29(6):602-8. doi: 10.1002/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-L. Erratum in: Am J Ind Med 1996 Sep;30(3):372. PMID: 8773720. Pubmed
  2. Roy JS, MacDermid JC, Woodhouse LJ. Measuring shoulder function: a systematic review of four questionnaires. Arthritis Rheum. 2009 May 15;61(5):623-32. doi: 10.1002/art.24396. PMID: 19405008. Pubmed
  3. Gummesson C, Atroshi I, Ekdahl C. The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: longitudinal construct validity and measuring self-rated health change after surgery. BMC Musculoskelet Disord. 2003 Jun 16;4:11. doi: 10.1186/1471-2474-4-11. Epub 2003 Jun 16. PMID: 12809562; PMCID: PMC165599.
  4. Mintken PE, Glynn P, Cleland JA. Psychometric properties of the shortened disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) and Numeric Pain Rating Scale in patients with shoulder pain. J Shoulder Elbow Surg. 2009 Nov-Dec;18(6):920-6. doi: 10.1016/j.jse.2008.12.015. Epub 2009 Mar 17. PMID: 19297202.
  5. Netter’s Orthopaedic Clinical Examination An Evidence-Based Approach 3rd Edition Book.
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