Psychometric Properties of the Hindi Version of the Disabilities of Arm, Shoulder, and Hand: A Pilot Study

Systematic review of the quality of the cross-cultural adaptations of Disabilities of the Arm, Shoulder and Hand (DASH)

BACKGROUND

The Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Measure is a widely used patient reported outcome measure.

OBJECTIVE

The aim of this study is to evaluate the quality of translation procedures and assessment of the psychometric properties of cross-cultural adaptations of the DASH.

METHODS

We reviewed the literature to identify all published studies of cultural adaptations of the DASH questionnaire. For the quality assessment, we used Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures, Quality Criteria for Psychometric Properties of Health Status Questionnaire and COSMIN Checklist for Cross-Cultural Validity.

RESULTS

We included 25 articles with 26 versions of the DASH. Only the Puerto Rican version followed all six of the processes of cross-cultural adaptation. None of the versions assessed all eight measurement properties for Quality Criteria for Psychometric Properties of Health Status Questionnaire and none of them had a positive rating from agreement, internal consistency, responsiveness and interpretability. All the studies got a poor rating according to the COSMIN checklist.

DISCUSSION

None of the versions got a good rating from all three checklists. We observed that supplementary tests for the adaptations are necessary, especially for assessing agreement, responsiveness and interpretability. We concluded that all versions need more research on psychometric properties.

Shoulder and scapula muscle training plus conventional physiotherapy versus conventional physiotherapy only: a randomized controlled trial of patients with lateral elbow tendinopathy

BACKGROUND

Previous studies have suggested that weakening of shoulder and scapula muscles have been associated with increased pain, and decreased functional abilities in patients with lateral elbow tendinopathy (LET).

PURPOSE

To compare the effects of shoulder and scapula muscle training plus conventional physiotherapy with conventional physiotherapy only.

METHODS

A group of 48 patients with LET was randomly allocated into two groups: shoulder and scapula muscle training plus conventional physiotherapy (n = 24), and conventional physiotherapy (n = 24). All patients received 12 sessions of treatment for 4 weeks. Furthermore, both groups were instructed to continue their own exercise program at home until four months after the end of treatment. Pain intensity, grip strength, and functional status were measured preintervention, postintervention, and 4 months after the end of intervention (4-month follow-up).

RESULTS

The shoulder and scapula muscle training plus conventional physiotherapy group showed significantly more reduction in pain and greater improvement in functional status compared with conventional physiotherapy group, but there was no significant difference in pain-free grip strength for two groups.

CONCLUSION

Conventional physiotherapy combined with shoulder and scapula muscle training could be more effective in improving the pain and functional abilities of patients with LET compared with conventional physiotherapy only.

Psychometric properties of patient-reported outcome questionnaires for patients with musculoskeletal disorders of the shoulder

PURPOSE

To evaluate the psychometric properties of self-administered patient-reported outcome (PRO) questionnaires which were used in non-surgical homogeneous populations with musculoskeletal shoulder disorders.

METHODS

The included studies were identified using eligibility criteria. The methodological quality of each article was assessed using the COSMIN checklist. The psychometric properties of original versions and translated versions of PROs were also assessed.

RESULTS

Twenty articles were included. Two musculoskeletal shoulder disorders were identified that met the selection criteria: rotator cuff disease and glenohumeral instability. A total of 11 PROs were identified. In general, the methodological quality of the included studies is fair or poor. The Western Ontario Rotator Cuff Index (WORC) and the Shoulder Pain and Disability Index (SPADI) are the most frequently evaluated PROs for patients with rotator cuff disease, and their psychometric properties seem to vary according to what language that they are in. For glenohumeral instability, the Western Ontario Shoulder Instability Index (WOSI) and the Oxford Instability Shoulder Score (OISS) are the most frequently evaluated PROs, and their psychometric properties seem to be adequate.

CONCLUSION

Using for rotator cuff disease is advised, for Norwegian users, the SPADI, WORC, Oxford Shoulder Score, and disabilities of the arm, shoulder and hand. Dutch and Persian users could use the WORC. For Greek speakers, the SPADI is recommended. Turkish users could use the rotator cuff quality-of-life measure. For glenohumeral instability, Dutch and Norwegian speakers could use the WOSI and the OISS. Italian, Japanese, and Turkish users could use the WOSI. For English users, the OISS and the Shoulder Rating Questionnaire are recommended.

LEVEL OF EVIDENCE

III.

Tamil Translation, Cross-Cultural Adaptation, and Pilot Testing of the Disabilities of Arm, Shoulder, and Hand Questionnaire

BACKGROUND

The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire is a commonly used patient-reported outcome measure of symptoms and function in people with upper limb conditions. The objectives of this study were to translate and cross-culturally adapt the DASH questionnaire for Tamil population in India and pilot test the questionnaire for feasibility and acceptability.

MATERIALS AND METHODS

The translation and cross-cultural adaptation process recommended by the developers of the DASH questionnaire was followed. The prefinal Tamil DASH was tested in people with a wide range of upper limb conditions. Acceptability and feasibility was evaluated by patient feedback and the time taken to complete the questionnaire.

RESULTS

Around 11 items were adapted to improve the relevance of the questionnaire for Tamil population. Thirty patients were recruited for pilot testing. The prefinal Tamil DASH was found to be relevant and comprehensible to patients (n = 29, Males/Females: 21/8; mean (SD) age: 34 (11.3) years) and feasible to administer. One item "Sexual activities" had more non-respondents (n = 16, 55%). Upon consultation with the developers, an item "Wash and blow dry hair" was further modified and the final Tamil DASH was produced.

CONCLUSION

Evaluation of reliability, validity and responsiveness in a large sample would inform the use of Tamil DASH in clinical and research settings.