From: The responsiveness of the PROMIS instruments and the qDASH in an upper extremity population
Item | Question |
---|---|
Please rate your ability to do the following activities in the last week. | |
1 | Open a tight or new jar.a |
2 | Do heavy household chores (e.g., wash walls, floors).a |
3 | Carry a shopping bag or briefcase.a |
4 | Wash your back.a |
5 | Use a knife to cut food.a |
6 | Recreational activities in which you take some force or impact through your arm, shoulder or hand (e.g., golf, hammering, tennis, etc.).a |
7 | During the past week, to what extent has your arm, shoulder or hand problem interfered with your normal social activities with family, friends, neighbors or groups?b |
8 | During the past week, were you limited in your work or other regular daily activities as a result of your arm, shoulder or hand problem?c |
Please rate the severity of the following symptoms in the last week. | |
9 | Arm, shoulder or hand pain.d |
10 | Tingling (pins and needles) in your arm, shoulder or hand.d |
11 | During the past week, how much difficulty have you had sleeping because of the pain in your arm, shoulder or hand?a |