QuickDash Scorer

Main Assessment

No
Difficulty
Mild
Difficulty
Moderate
Difficulty
Severe
Difficulty
Unable
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 (e.g., golf, hammering, tennis, etc.). 1 2 3 4 5
Not
at all
Slightly Moderately Quite
a bit
Extremely
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? 1 2 3 4 5
Not limited
at all
Slightly
limited
Moderately
limited
Very
limited
Unable
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? 1 2 3 4 5
Please rate the severity of the following symptoms in the last week. None Mild Moderate Severe Extreme
9) Arm, shoulder or hand pain 1 2 3 4 5
10) Tingling (pins and needles) in your arm, shoulder or hand. 1 2 3 4 5
No
Difficulty
Mild
Difficulty
Moderate
Difficulty
Severe
Difficulty
Unable
11) During the past week, how much difficulty have you had sleeping because of the pain in your arm, shoulder or hand? 1 2 3 4 5

Work module

Have you had difficulty: No
Difficulty
Mild
Difficulty
Moderate
Difficulty
Severe
Difficulty
Unable
1) using your usual technique for your work? 1 2 3 4 5
2) doing your usual work because of arm, shoulder or hand pain? 1 2 3 4 5
3) doing your work as well as you would like? 1 2 3 4 5
4) spending your usual amount of time doing your work? 1 2 3 4 5

Sports/Arts Module

Did you have any difficulty: No
Difficulty
Mild
Difficulty
Moderate
Difficulty
Severe
Difficulty
Unable
1) using your usual technique for playing your instrument or sport? 1 2 3 4 5
2) playing your musical instrument or sport because of arm, shoulder or hand pain? 1 2 3 4 5
3) playing your musical instrument or sport as well as you would like? 1 2 3 4 5
4) spending your usual amount of time practising or playing your instrument or sport? 1 2 3 4 5
Sum of responses:
Number of responses:
Per cent impairment: