Appendix I.
PROMIS v1.2 Upper Extremity item bank.
| Item | ID | Question |
|---|---|---|
| 1 | PFA16r1 | Are you able to dress yourself, including tying shoelaces and buttoning your clothes? |
| 2 | PFA17 | Are you able to reach into a high cupboard? |
| 3 | PFA18 | Are you able to use a hammer to pound a nail? |
| 4 | PFA20 | Are you able to cut your food using eating utensils? |
| 5 | PFA28 | Are you able to open a can with a hand can opener? |
| 6 | PFA29r1 | Are you able to pull heavy objects (10 pounds/5 kg) towards yourself? |
| 7 | PFA35 | Are you able to open and close a zipper? |
| 8 | PFA38 | Are you able to dry your back with a towel? |
| 9 | PFA44 | Are you able to put on a shirt or blouse? |
| 10 | PFA48 | Are you able to peel fruit? |
| 11 | PFA54 | Are you able to button your shirt? |
| 12 | PFB21 | Are you able to pick up coins from a table top? |
| 13 | PFB22 | Are you able to hold a plate full of food? |
| 14 | PFB30 | Are you able to open a new milk carton? |
| 15 | PFB33 | Are you able to remove something from your back pocket? |
| 16 | PFB36 | Are you able to put on a pullover sweater? |
Note: Response options for questions 1–16 are 1 = Unable to do; 2 = With much difficulty; 3 = With some difficulty; 4 = With a little difficulty; or 5 = Without any difficulty.