Thursday, November 22, 2012

How Much Are Upper or Lower Extremity Disabilities Associated with General Health Status in the Elderly? CORR

How Much Are Upper or Lower Extremity Disabilities Associated with General Health Status in the Elderly? CORR

This paper uses a population of 272 individuals without a history of surgery for musculoskeletal disease or trauma to test the hypothesis that the DASH score (Disabilities of the Arm Shoulder and Hand - a self-reported measure of upper extremity comfort and function) is correlated with the SF 36 (a self-reported measure of overall well-being. Not surprisingly, the results of the two are correlated, the DASH is particularly associated with the physical component summary scale of the SF 36.

In that there was no documentation of the presence of upper extremity disability in these individuals, one might expect that the observed effect would have been even stronger in those with known rotator cuff tears, arthritis, carpal tunnel syndrome and the like. We have previously reported on the correlation of comorbidity with function of the shoulder and health status of patients who have glenohumeral degenerative joint disease and on the relationship of the SF 36 and shoulder function in degenerative disease and rheumatoid arthritis.

What was particularly interesting was the effect of gender and age on the DASH. Recalling that a score of 0 is no disability and 100 is total disability, males averaged a score of 15.67 ± 13.34 while women average 27.07 ± 20.00 (p<0.001). Individuals aged 65 to 75 averaged 19.60 ± 17.20 while those over 75 averaged  24.68 ± 18.80 (p<0.029).  This indicates that, in contrast to the usual practice, DASH scores need to be normalized by age and gender and that combining ages and genders in reporting results may lead to erroneous conclusions.


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