Mayo Elbow Performance Score


1. Pain (tick only one)

None

Mild

Moderate

Severe

2. Range of motion (tick only one)

Arc > 100 degrees

Arc 50 to 100 degrees

Arc < 50 degrees

3. Stability (tick one only)

Stable

Moderately unstable

Grossly unstable

4. Function (Tick as many as apply)

Able to comb hair

Able to feed oneself

Able to perform personal hygiene tasks

Able to on shirt

Able to put on shoes

Total

Your Mayo elbow score is:   This is out of a total of 100.


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Revised: 02/13/12