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Table 8 qDASH item bank

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
  1. aResponse options for questions 1–6, 11 are 1 = No difficulty; 2 = Mild difficulty; 3 = Moderate difficulty; 4 = Severe difficulty; 5 = So much difficulty that I can’t sleep
  2. bResponse options for question 7 are 1 = Not at all; 2 = Slightly; 3 = Moderately; 4 = Quite a bit; 5 = Extremely
  3. cResponse options for question 8 are 1 = Not limited at all; 2 = Slightly limited; 3 = Moderately limited; 4 = Very limited; 5 = Unable
  4. dResponse options for questions 9–10 are 1 = None; 2 = Mild; 3 = Moderate; 4 = Severe; 5 = Extreme