Background Musculoskeletal complaints influence disability, but the relative contribution of concurrent upper and lower extremity health-related quality of life (HRQOL) on patient perceptions of disability is unclear.
Objectives We evaluated whether two disease specific quality of life instruments (DASH and WOMAC) reflect a patient's perception of general disability using the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) and determined whether disability components are explained by upper and lower extremity HRQOL.
Methods We recruited 421 randomly chosen participants 50 years or older without stroke, cancer, or history of surgery for musculoskeletal disease who participated in the Namgang Cohort. Upper extremity HRQOL was determined with the DASH score and lower extremity HRQOL with the WOMAC; as a measure of disability, we obtained WHODAS 2.0 component. Multiple regression modeling was used to assess the relative contributions made by upper and lower extremity HRQOL to disability.
Results Most patients reported knee pain (61.0%), shoulder (17.1%), elbow (28.5%) and hand (56.1%). Mean WHODAS 2.0 total score was 28.06 (SD=14.2), corresponding to mild to moderate disability and WOMAC and DASH scores were 23.2 (SD=22.1) and 22.4 (SD=19.3). When adjusted for age, sex, level of education, spouse, self rated health, hypertention, DM and depression, the DASH total score was correlated with the getting around (β=0.137, p=0.032) and social participation (β=0.226, p<0.001) and the WOMAC total score was correlated with the getting around (β=0.362, p<0.001) and social participation (β=0.289, p<0.001)
Conclusions We found that in a community-based population, perceived actibity limitation and social participation were associated with upper and lower extremity HQRQOL. Since the WHODAS 2.0 does not target a specific disease (as oppose to the DASH, WOMAC), it can be used to compare disabilities caused by different diseases.
Pösl M, Cieza A, Stucki G. Psychometric properties of the WHODASII in rehabilitation patients. Qual Life Res. 2007;16(9):1521–31.
Silva C, Coleta I, Silva AG, Amaro A, Alvarelhão J, Queirόs A, Rocha N. Adaptation and validation of WHODAS 2.0 in patients with musculoskeletal pain. Rev Saude Publica. 2013 Aug;47(4):752–8.
Tazaki M, Yamaguchi T, Yatsunami M, Nakane Y. Measuring functional health among the elderly: development of the Japanese version of the World Health Organization Disability Assessment Schedule II. Int J Rehabil Res. 2014 Mar;37(1):48–53.
Acknowledgements This work was supported from the Ministry of Agriculture Food and Rural Affairs in Korea.
Disclosure of Interest None declared
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.