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QuickDASH Assessment Questionnaire

This document contains an 11-item questionnaire called the QuickDASH used to assess upper limb disability and symptoms over the past week. It asks patients to rate on a 5-point scale difficulties with various physical activities, interference with social activities, and limitations in work or daily activities due to arm, shoulder, or hand problems. It also asks patients to rate the severity of symptoms like pain, tingling, and difficulty sleeping due to pain. Scores are calculated to determine the level of disability and symptoms experienced.

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Louise Axalan
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2K views1 page

QuickDASH Assessment Questionnaire

This document contains an 11-item questionnaire called the QuickDASH used to assess upper limb disability and symptoms over the past week. It asks patients to rate on a 5-point scale difficulties with various physical activities, interference with social activities, and limitations in work or daily activities due to arm, shoulder, or hand problems. It also asks patients to rate the severity of symptoms like pain, tingling, and difficulty sleeping due to pain. Scores are calculated to determine the level of disability and symptoms experienced.

Uploaded by

Louise Axalan
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
  • QuickDASH Health Questionnaire

QuickDASH

Please rate your ability to do the following activities in the last week by circling the number below the appropriate response.

NO MILD MODERATE SEVERE


UNABLE
DIFFICULTY DIFFICULTY DIFFICULTY DIFFICULTY

1. Open a tight or new jar. 1 2 3 4 5

2. Do heavy household chores (e.g., wash walls, floors). 1 2 3 4 5

3. Carry a shopping bag or briefcase. 1 2 3 4 5

4. Wash your back. 1 2 3 4 5

5. Use a knife to cut food. 1 2 3 4 5

6. Recreational activities in which you take some force


or impact through your arm, shoulder or hand 1 2 3 4 5
(e.g., golf, hammering, tennis, etc.).

QUITE
NOT AT ALL SLIGHTLY MODERATELY EXTREMELY
A BIT

7. During the past week, to what extent has your


arm, shoulder or hand problem interfered with 1 2 3 4 5
your normal social activities with family, friends,
neighbours or groups?

NOT LIMITED SLIGHTLY MODERATELY VERY


UNABLE
AT ALL LIMITED LIMITED LIMITED

8. During the past week, were you limited in your


work or other regular daily activities as a result 1 2 3 4 5
of your arm, shoulder or hand problem?

Please rate the severity of the following symptoms


in the last week. (circle number) NONE MILD MODERATE SEVERE EXTREME

9. Arm, shoulder or hand pain. 1 2 3 4 5

10. Tingling (pins and needles) in your arm, 1 2 3 4 5


shoulder or hand.

SO MUCH
NO MILD MODERATE SEVERE DIFFICULTY
DIFFICULTY DIFFICULTY DIFFICULTY DIFFICULTY THAT I
CAN’T SLEEP

11. During the past week, how much difficulty have


you had sleeping because of the pain in your arm, 1 2 3 4 5
shoulder or hand? (circle number)

( )
QuickDASH DISABILITY/SYMPTOM SCORE = (sum of n responses) - 1 x 25, where n is equal to the number
of completed responses. n
A QuickDASH score may not be calculated if there is greater than 1 missing item.

Please rate your ability to do the following activities in the last week by circling the number below the appropriate respons

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