[Spanish version of the DASH questionnaire. Cross-cultural adaptation, reliability, validity and responsiveness].

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.