Quick DASH

INSTRUCTIONS
This questionnaire asks about your symptoms as well as your ability to perform certain activities.
Please answer every question, based on your condition in the last week, by selecting the appropriate answer.
If you did not have the opportunity to perform an activity in the past week, please make your best estimate of which response would be the most accurate.
It doesn’t matter which hand or arm you use to perform the activity; please answer based on your ability regardless of how you perform the task.

Please rate your ability to do the following activities in the last week by ticking the box next to the appropriate response.

It is important you only tick one box per question.

1. Open a tight or new jar.

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

2. Do heavy household chores (e.g., wash walls, floors).

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

3. Carry a shopping bag or briefcase.

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

4. Wash your back.

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

5. Use a knife to cut food.

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

6. Recreational activities in which you take some force or impact through your arm, shoulder or hand (e.g., golf, hammering, tennis, etc.).

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

7. During the past week, to what extent has your arm, shoulder or hand problem interfered with your normal social activities with family, friends, neighbours or groups?

Not at all

Slightly

Moderately

Quite a bit

Extremely

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?

Not limited at all

Slightly limited

Moderately limited

Very limited

Unable

Please rate the severity of the following symptoms in the last week.

9. Arm, shoulder or hand pain.

None

Mild

Moderate

Severe

Extreme

10. Tingling (pins and needles) in your arm, shoulder or hand.

None

Mild

Moderate

Severe

Extreme

11. During the past week, how much difficulty have you had sleeping because of the pain in your arm, shoulder or hand? (circle number)

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

So much difficulty that I can't sleep

Your QuickDASH total  is: