Clinical validation of video DASH for upper limb disorders in rheumatic patients

The Disabilities of the Arm, Shoulder and Hand (DASH) is a widely validated 30-item self-administered instrument used to quantify upper limb disability. In rheumatoid arthritis, limitations in construct validity have been reported in certain subgroups; therefore, a multimedia version (video-DASH), incorporating illustrative videos for each item, may improve comprehension and response consistency.

To evaluate the psychometric properties and acceptability of the video-DASH in patients with rheumatological diseases affecting the upper limb.

A prospective methodological validation study including 28 participants (≥18 years) with a confirmed rheumatological diagnosis involving the upper limb. Exclusion criteria were severe cognitive impairment, visual or hearing limitations precluding interaction with the multimedia version, and surgery or acute upper limb injury within the previous 3 months. The questionnaire was administered at three time points. Internal consistency (Cronbach's α), test-retest reliability (intraclass correlation coefficient, ICC), longitudinal comparisons (Wilcoxon test with Holm correction), and agreement (Bland-Altman analysis) were assessed. A comprehension and satisfaction survey was also administered.

Mean age was 55.5±9.06 years (34-72), and the predominant diagnosis was rheumatoid arthritis (92.9%). Mean scores decreased from 31.93 to 26.53 and 23.08, with significant differences across comparisons. Internal consistency was high (α=0.961, 0.979, and 0.987), and reliability was adequate (ICC=0.785-0.940). Bland-Altman analysis showed minimal bias. All participants reported adequate comprehension and positive satisfaction.

The video-DASH demonstrates good reliability and acceptability, supporting its use as a tool to assess upper limb function in patients with rheumatic disease.