Responsiveness of a 1-Year Recall Modified DASH Work Module in Active Workers with Upper Extremity Musculoskeletal Symptoms.

Abstract

To evaluate the responsiveness to change of a modified version of the Work module of the Disabilities of the Arm, Shoulder, and Hand (DASH-W) in a prospective, longitudinal cohort study of active workers. We compared change on a 1-year recall modified DASH-W to change on work ability, work productivity, and symptom severity, according to predetermined hypotheses following the Consensus-based standards for the selection of health measurement instruments (COSMIN). We evaluated concordance in the direction of change, and magnitude of change using Spearman rank correlations, effect sizes (ES), standardized response means (SRM), and area under the receiver operating characteristic curves (AUC). In a sample of 551 workers, change in 1-year recall modified DASH-W scores showed moderate correlations with changes in work ability, work productivity, and symptom severity (r = 0.47, 0.44, and 0.36, respectively). ES and SRM were moderate for 1-year recall modified DASH-W scores in workers whose work ability (ES = -0.58, SRM = -0.52) and work productivity improved (ES = -0.59, SRM = -0.56), and larger for workers whose work ability (ES = 1.24, SRM = 0.68) and work productivity worsened (ES = 1.02, SRM = 0.61). ES and SRM were small for 1-year recall modified DASH-W scores of workers whose symptom severity improved (-0.32 and -0.29, respectively). Responsiveness of the 1-year recall modified DASH-W was moderate for those whose symptom severity worsened (ES = 0.77, SRM = 0.50). AUC met responsiveness criteria for work ability and work productivity. The 1-year recall modified DASH-W is responsive to changes in work ability and work productivity in active workers with upper extremity symptoms.