PURPOSE: Duchenne muscular dystrophy can lead to upper extremity limitations, 
pain and stiffness. In a previous study, these domains have been investigated 
using extensive questionnaires, which are too time-consuming for clinical 
practice. This study aimed at gaining insight into the underlying dimensions of 
these questionnaires, and to construct a short questionnaire that can be used 
for clinical assessment.
METHODS: Exploratory factor analysis was performed on the responses of 213 
participants to a web-based survey to find the underlying dimensions in the 
Capabilities of Upper Extremity questionnaire, the ABILHAND questionnaire, and 
questionnaires regarding pain and stiffness. Based on these underlying 
dimensions, a stepwise approach was formulated. In addition, construct validity 
of the factors was investigated.
RESULTS: In total, 14 factors were identified. All had high internal consistency 
(Cronbach's alpha >0.89) and explained 80-88% of the variance of the original 
questionnaires. Construct validity was supported, because participants in the 
early ambulatory stage performed significantly better (p< 0.001) than 
participants in the late non-ambulatory stage.
CONCLUSION: The factors identified from the set of questionnaires provide a 
valid representation of upper extremity function, pain and stiffness in Duchenne 
muscular dystrophy. Based on the factor commonalities, the Upper Limb Short 
Questionnaire was formulated. Implications for Rehabilitation New insights into 
the underlying dimensions of upper extremity function, pain and stiffness in 
Duchenne muscular dystrophy are gained. Fourteen factors, with good internal 
consistency and construct validity, are identified regarding upper extremity 
function, pain and stiffness in Duchenne muscular dystrophy. Based on these 
factors, the Upper Limb Short Questionnaire is presented. The Upper Limb Short 
Questionnaire can be used as an identifier of arm-hand limitations and the start 
of more thorough clinical investigation.