Granted, persons with upper-limb disorders often use assistive devices, such as splints or specialized equipment, to improve their ability to perform activities. In fact, some measures, while permitting the use of an assistive device, subsequently weight the patient’s score on that basis (Fries 1982). The intent of the DASH/QuickDASH is to determine how well a person can do an activity regardless of how it is done. Respondents are therefore asked to rate their ability using the assistive device if that is their usual practice at the time. However, this approach does not allow them to rate their ability when the assistance of another person is involved. The use of an assistant is arguably more a reflection of the environment than of the autonomy of the person with the disability. In this situation, respondents are asked to rate their own ability rather than their assisted ability.
