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Disability of the arm, shoulder and hand questionnaire in Swedish patients with rheumatoid arthritis: a validity study

Journal article
Authors Annelie Bilberg
Tomas Bremell
Kaisa Mannerkorpi
Published in Journal of Rehabilitation Medicine
Volume 44
Issue 1
Pages 7-11
ISSN 1650-1977
Publication year 2012
Published at Institute of Medicine, Department of Rheumatology and Inflammation Research
Institute of Medicine
Pages 7-11
Language en
Keywords disability evaluation, rheumatoid arthritis, upper extremity, reliability, validity, questionnaire
Subject categories Nursing


Objective: The aim of this study was to assess the reliability and validity of the Disability of the Arm, Shoulder and Hand (DASH) questionnaire in a Swedish rheumatoid arthritis population. Methods: To investigate the concurrent and convergent validity, 67 patients with rheumatoid arthritis completed the DASH, the Health Assessment Questionnaire Disability Index (HAQ) and activity-induced pain. Active shoulder-arm motion, handgrip force and disease activity (Disease Activity Score in 28 joints; DAS28) were assessed. The test-retest reliability was investigated in 26 patients. Face validity was also investigated. Results: Spearman’s correlation coefficient revealed a significant association (p < 0.001) between the DASH score and HAQ index (rs 0.80), confirming satisfactory concurrent validity. A significant association (p ≤ 0.02) was found between the DASH score and active shoulder-arm motion (rs –0.38 to –0.50), handgrip force (rs –0.46 to –0.59), activity-induced pain (rs 0.66) and DAS28 (rs 0.63), confirming satisfactory convergent validity for the DASH questionnaire. Satisfactory test-retest reliability (intraclass correlation coefficient 0.99, 95% confidence interval 0.98–0.99) and face validity of the questionnaire were confirmed. Conclusion: The DASH questionnaire showed satisfactory test-retest reliability, concurrent-, convergent-, and face validity for patients with rheumatoid arthritis and can be recommended for use in rheumatoid arthritis populations.

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