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. 2013 Oct 12;6(1):35–39. doi: 10.1111/sae.12046

Table 1.

Patient-determined outcomes (based on the Shoulder Rating Questionnaire) [24]

1. How often is your shoulder …: (always, daily, weekly monthly, never)
  (a) Painful during activity?
  (b) Painful when you sleep?
2. What is the level of your shoulder pain: (very severe, severe, moderate, mild, none)
  (a) When you are resting?
  (b) With activities above your head?
  (c) When you sleep?
3. How ‘stiff’ is your shoulder? (very, quite, moderate, a little, not at all)
4. How much difficulty do you have: (very severe, severe, moderate, mild, none)
  (a) When reaching behind your back?
  (b) With activities above your head?
5. How is your shoulder overall? (very bad, bad, poor, fair, good)