Der Unfallchirurg

, Volume 110, Issue 6, pp 548–552 | Cite as

Reliabilität und Veränderungssensitivität der deutschen Version des Fragebogens Arm, Schulter und Hand (DASH)

Originalien

Zusammenfassung

Hintergrund

Die deutsche Version des Fragebogens DASH („disability of shoulder, arms and hand questionnaire“) ist hinsichtlich ihrer Validität und von Teilaspekten ihrer Reliabilität untersucht worden. Daten zur Test-Retest-Reliabilität und Veränderungssensitivität wurden jedoch bisher nicht publiziert. Gegenstand der vorliegenden Studie war die Untersuchung dieser beiden wesentlichen Eigenschaften des Instruments.

Methoden

71 von 101 konsekutiven Patienten mit distalen Radiusfrakturen wurden prospektiv über 1 Jahr beobachtet und zu 3 Zeitpunkten untersucht. Zur Beurteilung der Reliabilität wurde die innere Konsistenz (Cronbachs α) und die Korrelation der Ergebnisse des Fragebogens nach 12 und 13 Wochen bestimmt (Spearman-Korrelationskoeffizient, Intraklassenkorrelationskoeffizient). Die Veränderungssensitivität des Fragebogens wurde durch Berechnung der Parameter „Change Score“, „Standardised Effect Size“ (SES) und „Standardised Response Mean“ (SRM) bestimmt und mit denselben Parametern für die traditionellen Bewertungskriterien Griffstärke und Bewegungsausmaß verglichen.

Ergebnisse

Der Fragebogen zeigte eine exzellente innere Konsistenz und Test-Retest-Reliabilität (Cronbachs α >0,95; r=0,912; ICC=0,945) und eine mittlere Veränderungssensitivität (Change Score =8,93; SRM=0,55, SES=0,41). Die Veränderungssensitivität traditioneller Bewertungskriterien war höher (Griffstärke SRM=0,8; SES=0,62; ROM-SRM=0,76; SES=0,71).

Schlussfolgerungen

Die deutsche Version des Fragebogens kann als reliables und veränderungssensitives Instrument für die Bewertung von Behandlungsergebnissen nach distalen Radiusfrakturen empfohlen werden. Traditionelle Instrumente widerspiegeln ebenso wesentliche funktionelle Aspekte und sollten in die Ergebnisbewertung einfließen.

Schlüsselwörter

Radiusfrakturen Ergebnisbewertung Reliabilität Veränderungssensitivität 

Reliability and responsiveness of the German version of the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH)

Abstract

Background

Whilst there are some studies which have focussed on the validity and also others partially on the reliability of the German version of the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH), studies regarding test-retest reliability and responsiveness do not exist. The purpose of this study was to analyse these two meaningful properties of the officially approved German version of the DASH.

Methods

Of 101 consecutive patients with distal radius fractures, 72 were followed prospectively at three time intervals. To evaluate the reliability, internal consistency (Cronbach’s alpha) and correlation between the DASH points from the 12- and 13-week examinations (Spearman’s correlation coefficient and intra-class coefficient) were calculated. Responsiveness was assessed using the parameters change score, standardised effect size and standardised response mean. These values were compared with the same values obtained from the traditional measures of grip strength and range of motion.

Results

Internal consistency and test-retest reliability of the DASH were excellent (Cronbach’s alpha >0.95, Spearman’s correlation coefficient r=0.912, ICC=0.945). Responsiveness of the DASH was moderate (change score=8.93, SRM=0.55, SES=0.41). Responsiveness of the ROM deficit and grip strength were larger than that for data from the DASH.

Conclusion

The German DASH is a reliable and responsive measure. It can detect changes in disabilities over time in patients with distal radius fractures. Traditional impairment measures reflect important functional aspects and should be included in clinical outcome evaluation.

Keywords

Radius fractures Outcome assessment Reliability Responsiveness 

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Copyright information

© Springer Medizin Verlag 2007

Authors and Affiliations

  1. 1.Sektion Unfallchirurgie und Orthopädie, Klinik für ChirurgieKlinikum SüdRostockDeutschland
  2. 2.Klinik für UnfallchirurgieUniversitätsklinkum, Otto-von-Guericke-UniversitätMagdeburgDeutschland

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