[Spanish version of the DASH questionnaire. Cross-cultural adaptation, reliability, validity and responsiveness]. / Versión española del cuestionario DASH. Adaptación transcultural, fiabilidad, validez y sensibilidad a los cambios.

BACKGROUND AND OBJECTIVE: The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is a specific outcome instrument developed to measure upper-extremity disability and symptoms. The aim of this work is to develop a Spanish version of the DASH questionnaire and to analyze its reliability, validity and responsiveness. MATERIAL AND METHOD: We performed cross-cultural adaptation of the DASH to Spanish, using a process that included double forward and backward translations, expert review and field-testing. The Spanish version's reliability, content, construct and criterion validity and responsiveness were then evaluated in 98 patients with upper-extremity conditions that completed the DASH and SF-36 generic health questionnaire before and after medical rehabilitation treatment. RESULTS: We obtained a Spanish DASH version (DASHe) linguistically and conceptually equivalent to the original version. Internal consistency of the DASHe was high (Cronbach alpha = 0.96), test-retest reliability was excellent (r = 0.96) and the floor and ceiling effects were negligible. Construct and criteria validity was shown by a positive association of DASHe scores with worse condition, and a significant correlation with the SF-36 scores, stronger with the SF-36 pain dimension. Responsiveness was excellent (effect size and standardized response means higher than 0.80). CONCLUSIONS: The DASHe is a reliable, valid and responsive instrument that can provide a standardized measure in Spanish patients with upper-extremity musculoskeletal conditions.

Versión española del cuestionario DASH. Adaptación transcultural, fiabilidad, validez y sensibilidad a los cambios / Spanish version of the DASH questionnaire. Cross-cultural adaptation, reliability, validity and responsiveness

Fundamento y objetivo: El cuestionario Disabilities of the Arm, Shoulder and Hand (DASH) es un instrumento específico de medición de la calidad de vida relacionada con los problemas del miembro superior. El objetivo de este trabajo ha sido desarrollar una versión española del DASH y analizar su fiabilidad, validez y sensibilidad a los cambios. Material y método: Se ha realizado una adaptación transcultural del cuestionario DASH siguiendo el método de traducción-retrotraducción. Para el análisis de validez se utilizó una cohorte de 98 pacientes con problemas de miembro superior que cumplimentaron la versión española (DASHe) y un cuestionario general de calidad de vida (SF-36) al inicio y final del tratamiento. Se valoraron la fiabilidad, reproducibilidad, validez de contenido, validez de constructo, validez de criterio y la sensibilidad a los cambios. Resultados: Se obtuvo una versión española lingüística y conceptualmente equivalente a la original. El DASHe mostró excelentes resultados en cuanto a consistencia interna (alfa de Cronbach = 0,96), prueba test-retest (r = 0,96), práctica ausencia de efectos techo y suelo, sus puntuaciones se asociaron a características de los pacientes que indican peor estado de salud, mostró correlaciones significativas con todas las dimensiones del SF-36, y especialmente con la dimensión dolor, y presentó una excelente sensibilidad a los cambios (tamaño del efecto y respuesta media tipificada superiores a 0,80). Conclusiones: El DASHe es un instrumento equivalente a la versión original, válido, fiable y sensible a los cambios, que puede utilizarse en pacientes españoles con problemas de miembro superior

Background and objective: The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is a specific outcome instrument developed to measure upper-extremity disability and symptoms. The aim of this work is to develop a Spanish version of the DASH questionnaire and to analyze its reliability, validity and responsiveness. Material and method: We performed cross-cultural adaptation of the DASH to Spanish, using a process that included double forward and backward translations, expert review and field-testing. The Spanish version's reliability, content, construct and criterion validity and responsiveness were then evaluated in 98 patients with upper-extremity conditions that completed the DASH and SF-36 generic health questionnaire before and after medical rehabilitation treatment. Results: We obtained a Spanish DASH version (DASHe) linguistically and conceptually equivalent to the original version. Internal consistency of the DASHe was high (Cronbach alpha = 0.96), test-retest reliability was excellent (r = 0.96) and the floor and ceiling effects were negligible. Construct and criteria validity was shown by a positive association of DASHe scores with worse condition, and a significant correlation with the SF-36 scores, stronger with the SF-36 pain dimension. Responsiveness was excellent (effect size and standardized response means higher than 0.80). Conclusions: The DASHe is a reliable, valid and responsive instrument that can provide a standardized measure in Spanish patients with upper-extremity musculoskeletal conditions