Examination of the factor structure of the disabilities of the arm, shoulder, and hand questionnaire

Leigh A. Lehman, Michelle Woodbury, Craig A. Velozo

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


OBJECTIVE. The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire is a global scale evaluating the impact of upper-extremity disorders. We sought to validate or challenge the unidimensional factor structure of the DASH. METHOD. Secondary analysis was performed on data collected from outpatient clinics. Factor analysis was performed in two steps, exploratory factor analysis (EFA) followed by confirmatory factor analysis (CFA). To provide further support for unidimensionality, fit statistics were calculated using the Andrich Rasch ratingscale model. RESULTS. EFA revealed three potential factors (eigenvalues = 18.40, 1.56, and 1.54). CFA was performed fitting a three-factor model. Tucker-Lewis Index (.99) and standardized root mean square residual (.05) values indicated good fit. Comparative fit index (.89) and root mean square error of approximation (.13) did not. When divided into three constructs, only one item misfit. CONCLUSION. More research is needed to determine situations in which division of the DASH may enhance interpretability.

Original languageEnglish (US)
Pages (from-to)169-178
Number of pages10
JournalAmerican Journal of Occupational Therapy
Issue number2
StatePublished - Mar 2011
Externally publishedYes


  • Data interpretation
  • Disability evaluation
  • Factor analysis
  • Statistical
  • Upper extremity

ASJC Scopus subject areas

  • Occupational Therapy


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