Original articleReliability, validity and responsiveness of the French version of the questionnaire Quick Disability of the Arm, Shoulder and Hand in shoulder disorders
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.
Section snippets
Patients
Patients with common shoulder conditions (rotator cuff tendinopathies, frozen shoulder, osteoarthritis and proximal humeral fractures after bone healing) referred to a tertiary care rehabilitation unit were considered for inclusion in this study. Exclusion criteria were age less than 18 years; symptom duration of less than 2 months; shoulder pain originating from neurological or vascular disorders or neoplasms; referred pain from internal organs; systemic rheumatic conditions; inability to
Demographic and clinical data
Demographic and clinical characteristics are shown in Table 1. Sixty-five patients had rotator cuff tendinopathies, 32 frozen shoulder, 25 osteoarthritis and 31 fractures of the humeral head. The fracture group was a distinct group and its onset period was much shorter than that of others, with lower pain and disability scores as well. Data for 2 patients were excluded because of more than 1 unanswered item on the questionnaire. Four patients did not respond to item 6, related to recreational
Discussion
Our results strongly suggest that the F-QuickDASH-D/S scale can be used for evaluating shoulder conditions. The reliability and internal consistency of the F-QuickDASH-D/S scale were equal to those of the original (English) version (ICC 0.94 and Cronbach's alpha 0.89 vs 0.94 and 0.94, respectively, Beaton et al., 2005).
Although our ICC for test–retest can be considered excellent, graphic representation of the test–retest scores by the Bland and Altman method revealed that despite a marginal
Conclusion
The F-QuickDASH-D/S scale is a reliable, valid and responsive instrument for assessing disability in common shoulder disorders. Its psychometric properties are comparable to those of the full-length version of this scale. Therefore, the QuickDASH-D/S could be the preferred scale because it is easier and quicker to use.
Acknowledgement
The authors thank the patients who participated in the study and the technical staff of the Department of Rehabilitation Medicine, Cochin Hospital, Paris, France, for their help with data collection.
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