Skip to main content
SpringerLink
Log in

Responsiveness of the QuickDASH and SF-12 in Workers with Neck or Upper Extremity Musculoskeletal Disorders: One-Year Follow-Up

  • Published:
Journal of Occupational Rehabilitation Aims and scope Submit manuscript

Abstract

Introduction Questionnaires that measure functional status such as the Disability of the Arm, Shoulder and Hand (QuickDASH) and the Medical Outcomes Study 12-item Short-Form Health Survey (SF-12) can quantify the impact of health on performance. Little is known about whether these questionnaires can be used as a tool for measuring disabilities among workers. We compare the responsiveness of these two functional status questionnaires to changes in clinical outcomes of neck or upper extremity musculoskeletal disorders (UEMSD) among active workers in a longitudinal study. Methods We evaluated the effect size (ES) and standardized response means (SRM) of the QuickDASH and the SF-12 for 148 workers who were divided into four subgroups based on the diagnosis status change between baseline and 1-year visit. Results The ES and SRM for QuickDASH scores were 0.6/0.6 for the 50 subjects who became incident symptomatic neck or UEMSD cases, 1.3/1.0 for the 18 subjects who became incident clinical cases of neck or UEMSD, −1.0/−1.1 for the 46 subjects who recovered from having neck or UEMSD symptoms, and −1.1/−1.1 for the 34 subjects who recovered from being neck or UEMSD clinical cases. The correspondent ES/SRM for the QuickDASH work module were 0.4/0.3, 0.7/0.5, −0.6/−0.4, and −1.0/−0.8, respectively. The correspondent ES/SRM for the physical component scores of SF-12 (PCS12) for the four subgroups were 0.2/0.2, −0.9/−0.6, 0.3/0.2, and 0.3/0.3, respectively. Conclusions The QuickDASH scores were responsive to changes among active workers who were neck or UEMSD symptomatic or clinical case. PCS12 scores were sufficient only for use in clinical case status change.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bongers PM, Kremer AM, ter Laak J. Are psychosocial factors, risk factors for symptoms and signs of the shoulder, elbow, or hand/wrist? A review of the epidemiological literature. Am J Ind Med. 2002;41:315–42.

    Article  PubMed  Google Scholar 

  2. Aptel M, Aublet-Cuvelier A, Cnockaert JC. Work-related musculoskeletal disorders of the upper limb. Joint Bone Spine. 2002;69:546–55.

    Article  PubMed  Google Scholar 

  3. Silverstein BA, Welp E, Nelson NA, Kalat J. Claims incidence of work related musculoskeletal disorders of the upper extremities: Washington State, 1987 through 1995. Am J Public Health. 1998;88:1827–33.

    Article  PubMed  CAS  Google Scholar 

  4. Ashbury FD. Occupational repetitive strain injuries and gender in Ontario, 1986 to 1991. J Occup Environ Med. 1995;37:479–85.

    Article  PubMed  CAS  Google Scholar 

  5. Silverstein B, Adams D. Work-related musculoskeletal disorders of the neck, back and upper extremity in Washington State. Technical Report 40-11-2007. Washington State Department of Labor and Industries, Olympia Washington. 2007.

  6. Katz JN, Stock SR, Rempel D, Franzblau A, Gray RH. Classification criteria and severity assessment in work-associated upper extremity disorders: methods matter. Am J Ind Med. 2000;38:369–72.

    Article  PubMed  CAS  Google Scholar 

  7. Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sørensen F, Andersson G, Jørgensen K. Standardized Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987;18:233–7.

    Article  PubMed  CAS  Google Scholar 

  8. Franzblau A, Salerno DF, Armstrong TJ, Werner RA. Test-retest reliability of an upper-extremity discomfort questionnaire in an industrial population. Scand J Work Environ Health. 1997;23:299–307.

    PubMed  CAS  Google Scholar 

  9. Stock S, Streiner D, Tugwell P, Loisel P, Reardon R, Durand, MJ. 1996. Validation of the neck and upper limb index (NULI), a functional status instrument for work related musculoskeletal disorders. In 25ème Congrès annuel de la Commission internationale de santé au travail/CIST.

  10. Beaton DE, Davis AM, Hudak P, McConnell S. The DASH (disabilities of the arm, shoulder and hand) outcome measure: what do we know about it now. Br J Hand Ther. 2001;6:109–18.

    Google Scholar 

  11. Atroshi I, Gummesson C, Andersson B, Dahlgren E, Johansson A. The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire. Reliability and validity of the Swedish version evaluated in 176 patients. Acta Orthop Scand. 2000;71:613–8.

    Article  PubMed  CAS  Google Scholar 

  12. Offenbaecher M, Ewert T, Sangha O, Stucki G. Validation of a German version of the disabilities of arm, shoulder, and hand questionnaire (DASH-G). J Rheumatol. 2002;29:401–2.

    PubMed  Google Scholar 

  13. Padua R, Padua L, Ceccarelli E, Romanini E, Zanoli G, Amadio PC, Campi A. Italian version of the disability of the arm, shoulder and hand (DASH) questionnaire. Cross-cultural adaptation and validation. J Hand Surg [Br]. 2003;28:179–86.

    Google Scholar 

  14. Rosales RS, Delgado EB, De La Lastra-Bosch ID. Evaluation of the Spanish version of the DASH and carpal tunnel syndrome health-related quality-of-life instruments: cross-cultural adaptation process and reliability. J Hand Surg [Am]. 2002;27:334–43.

  15. Bot SD, Terwee CB, van der Windt DA, Bouter LM, Dekker J, de Vet HC. Clinimetric evaluation of shoulder disability questionnaires: a systematic review of the literature. Ann Rheum Dis. 2004;63:335–41.

    Article  PubMed  CAS  Google Scholar 

  16. Turchin DC, Beaton DE, Richards RR. Validity of observer-based aggregate scoring systems as descriptors of elbow pain, function, and disability. J Bone Joint Surg. 1998;80:154–62.

    PubMed  CAS  Google Scholar 

  17. Beaton DE, Wright JG, Katz JN. Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Joint Surg Am. 2005;87:1038–46.

    Google Scholar 

  18. McHorney CA, Ware JE Jr. Construction and validation of an alternate form general mental health scale for the Medical Outcomes Study Short-Form 36-Item Health Survey. Med Care. 1995;33:15–28.

    Article  PubMed  CAS  Google Scholar 

  19. Ware JE, Wright JG, Katz JN. A 12-item short-form health survey. Construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34:220–33.

    Article  PubMed  Google Scholar 

  20. Fan ZJ, Smith C, Silverstein BA. Assessing validity of the QuickDASH and SF-12 as surveillance tools among workers with neck or upper extremity musculoskeletal disorders. J Hand Ther. 2008;21:354–65.

    Google Scholar 

  21. Kirkley A, Griffin S, McLintock H, Ng L. The development and evaluation of a disease-specific quality of life measurement tool for shoulder instability. The Western Ontario Shoulder Instability Index (WOSI). Am J Sports Med. 1998;26:764–72.

    PubMed  CAS  Google Scholar 

  22. MacDermid JC, Richards RS, Donner A, Bellamy N, Roth JH. Responsiveness of SF-36, DASH and PRWE and physical impairments in evaluating recovery after distal radius fracture. J Hand Surg [Am]. 2000;25:330–340.

    Google Scholar 

  23. Silverstein BA, Viikari-Juntura E, Fan ZJ, Bonauto DK, Bao S, Smith C. Natural course of nontraumatic rotator cuff tendinitis and shoulder symptoms in a working population. Scand J Work Environ Health. 2006;32:99–108.

    PubMed  Google Scholar 

  24. ACGIH. Threshold limit values for chemical substances and physical agents and biological exposure indices. 2000.

  25. Sluiter JK, Rest KM, Frings-Dresen MHW. Criteria document for evaluating the work-relatedness of upper-extremity musculoskeletal disorders. Scand J Work Environ Health. 2001;27:1–102.

    PubMed  CAS  Google Scholar 

  26. Washington State Department of Labor and Industries. Diagnosis and treatment of work-related carpal tunnel syndrome. Med Treat Guidel. 2005;32–36.

  27. The Institute for Work & Health and American Academy of Orthopaedic Surgeon. The QuickDASH outcome measure. 2006.

  28. De Bruin AF, Diederiks PM, De Witte LP, Stevens FC, Philipsen H. Assessing the responsiveness of a functional status measure: the Sickness Impact Profile versus the SIP68. J Clin Epidemiol. 1997;50:529–540.

    Google Scholar 

  29. Terwee CB, Diederiks JP, Wiersinga WM, Prummel MF, Bossuyt PM. On assessing responsiveness of health-related quality of life instruments: guidelines for instrument evaluation. Qual Life Res. 2003;12:349–362.

    Google Scholar 

  30. Kazis LE, Anderson JJ, Meenan RF. Effect sizes for interpreting changes in health status. Med Care. 1989;27:S178–89.

    Article  PubMed  CAS  Google Scholar 

  31. Olejnik S, Algina J. Measures of effect size for comparative studies: applications, interpretations and limitations. Contemp Educ Psychol. 2000;25:241–86.

    Article  PubMed  Google Scholar 

  32. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Lawrence Erlbaum Associates; 1988.

  33. Liang MH, Fossel AH, Larson MG. Comparisons of five health status instruments for orthopedic evaluation. Med Care. 1990;28:632–42.

    Google Scholar 

  34. Hedges LV, Olkin I. Statistical methods for meta-analysis. Orlando: Academic Press; 1985.

    Google Scholar 

  35. 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;12:349–62.

    Google Scholar 

  36. Navsarikar A, Gladman DD, Husted JA, Cook RJ. Validity assessment of the disabilities of the arm, shoulder and hand questionnaire (DASH) for patients with psoriatic arthritis. J Rheumatol. 1999;26:2191–4.

    PubMed  CAS  Google Scholar 

  37. Kudielka BM, Hanebuth D, von Kanel R, Gander ML, Grande G, Fischer JE. Health-related quality of life measured by the SF12 in working populations: associations with psychosocial work characteristics. J Occup Health Psychol. 2005;10:429–40.

    Article  PubMed  Google Scholar 

  38. Dahlberg R, Karlqvist L, Bildt C, Nykvist K. Do work technique and musculoskeletal symptoms differ between men and women performing the same type of work tasks? Appl Ergon. 2004;35:521–9.

    Article  PubMed  Google Scholar 

  39. Silverstein B, Fan ZJ, Smith CK, Bao S, Howard N, Spielholz P, Bonauto D, Viikari-Juntura E. Gender adjustment or stratification in discerning upper extremity musculoskeletal disorder risk? Scand J Work Environ Health. 2009;35:113–26.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Safety & Health Assessment and Research for Prevention (SHARP), Washington State Department of Labor & Industries, PO Box 44330, Olympia, WA, 98504-4330, USA

    Z. Joyce Fan, Caroline K. Smith & Barbara A. Silverstein

Authors
  1. Z. Joyce Fan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Caroline K. Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Barbara A. Silverstein
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Z. Joyce Fan.

Appendix

Appendix

Case definitions of symptoms and physical findings of tension neck syndrome (TNS), rotator cuff syndrome (RCS), lateral epicondylitis (LE), wrist tendinitis (WT), and carpal tunnel syndrome (CTS).

Current Neck Symptoms

Neck pain, stiffness, spasm, burning, numbness or tingling in the neck region in the last 7 days, AND occurring more than three times or lasting more than 1 week in the previous 12 months, AND no traumatic injury onset.

Tension Neck Syndrome (TNS)

Tension neck syndrome: current symptoms AND positive physical examination: pain in neck/trapezius area with resisted head rotation, neck extension/flexion, or lateral rotation.

Current Shoulder Symptoms

Pain, stiffness, spasm, unable to raise arms, burning, numbness, or tingling of the shoulder region in the last 7 days, AND occurring more than three times or lasting more than 1 week in the previous 12 months, AND no traumatic injury onset.

Rotator Cuff Syndrome (RCS)

Current shoulder symptoms, AND positive physical examination in the same shoulder: resisted shoulder abduction, external rotation, internal rotation (pain in respective tendon insertion area) OR “painful arc” (pain in rotator cuff area with active shoulder abduction typically at 60–120°).

Current Elbow Symptoms

Pain, aching, stiffness, burning, numbness, or tingling in the elbow or forearm region in the past 7 days, AND occurring more than 1 week or occurred more than three times in the previous 12 months; AND no previous accident or sudden injury at the elbow/forearm area.

Lateral Epicondylitis (LE)

Current elbow symptoms at the lateral side of the elbow or forearm; AND positive physical examination on the same elbow: pain at the lateral humeral epicondyle region on resisted wrist extension or tenderness on palpation of the lateral epicondyle.

Current Hand/Wrist Symptoms

Pain, aching, stiffness, burning, numbness, or tingling in the hand/wrist in the last 7 days, AND occurring more than three times or lasting more than 1 week in the previous 12 months, AND no traumatic injury onset.

Wrist Tendinitis (WT)

Current symptoms and positive physical examinations: resisted wrist extension or flexion with the elbow extended.

Current Carpal Tunnel Syndrome Symptoms

Symptoms of burning, or pain/numbness/tingling in the planar median nerve distribution of the hand in the last 7 days, AND lasting for more than 1 week OR occurred more than three times in the previous 12 months, AND no acute traumatic onset.

Carpal Tunnel Syndrome (CTS)

Current symptoms AND positive electrodiagnostic test (NCV) in the same hand for distal median motor or sensory nerve which meets A and B or meets A and C below.

 

Criteria

Description

A

Median motor latency 8 cm > 4.5 ms, median sensory latency D2-wrist 14 cm > 3.5 ms, or mid palmar latency 8 cm > 2.2 ms

B

Ulnar sensory latency 14 cm < 3.7 ms

C

Median sensory latency (14 cm) minus ulnar sensory latency >0.5 ms. or mid-palmar difference >0.3 ms

Criteria were adapted from the Washington State Department of Labor and Industries Medical Treatment Guidelines [26].

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fan, Z.J., Smith, C.K. & Silverstein, B.A. Responsiveness of the QuickDASH and SF-12 in Workers with Neck or Upper Extremity Musculoskeletal Disorders: One-Year Follow-Up. J Occup Rehabil 21, 234–243 (2011). https://doi.org/10.1007/s10926-010-9265-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10926-010-9265-1

Keywords

Search

Navigation