I am a sports physical therapist working with a wide range of athletes with shoulder/arm injuries. In our clinic we use the DASH questionnaire to evaluate results before and after treatment. But the DASH isn't specific to shoulder or elbow and doesn't give a full measure of the athlete's function or ability to return-to-sport. Is there anything else out there that you know of we could use instead of the DASH (or maybe even along with the DASH)?
The Disabilities of the Arm, Shoulder, and Hand (DASH) Outcome Measure is a 30-item, self-report questionnaire designed to measure physical function and symptoms in people with any of several musculoskeletal disorders of the upper limb. The tool gives clinicians and researchers the advantage of having a single, reliable instrument that can be used to assess any or all joints in the upper extremity.
A shorter version called the QuickDASH is also available. Both tools are valid, reliable and responsive and can be used for clinical and/or research purposes. The full DASH Outcome Measure provides greater precision, so it may be the best choice for clinicians who wish to monitor arm pain and function in individual patients.
There is a new tool available called the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score (KJOC). It was developed by and named for (in part) the well-known orthopedic surgeon, Frank Jobe, MD. The KJOC has been pilot tested and then revised and retested on a larger group of overhead throwing athletes.
There are 10 questions about pain, missed games/practices, flexibility, weakness, stability, change in throwing patterns, and throwing velocity (speed) and power. A few questions also address level of competition, history of injury, and effects of arm problems on relationships with others (e.g., coaches, team players, agents, team managers).
The KJOC is designed to make sure the questions aren't just directed toward baseball pitchers but can be used with tennis players, volleyball players, swimmers, golfers, and others with upper extremity problems.
The KJOC will be tested further on many more athletes in order to confirm the results reported from this study. Reliability testing on a larger sample size is the next step. Follow-up of all athletes involved in these studies may also provide some additional useful information.
Frank G. Alberta, MD, et al. The Development and Validation of a Functional Assessment Tool for the Upper Extremity in the Overhead Athlete. In The American Journal of Sports Medicine. May 2010. Vol. 38. No. 5. Pp. 903-911.
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