Appendix IV.

qDASH item bank.

Item	Question
	Please rate your ability to do the following activities in the last week.
1	Open a tight or new jar.*
2	Do heavy household chores (e.g., wash walls, floors).*
3	Carry a shopping bag or briefcase.*
4	Wash your back.*
5	Use a knife to cut food.*
6	Recreational activities in which you take some force or impact through your arm, shoulder or hand (e.g., golf, hammering, tennis, etc.).*
7	During the past week, to what extent has your arm, shoulder or hand problem interfered with your normal social activities with family, friends, neighbors or groups?**
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?***
	Please rate the severity of the following symptoms in the last week.
9	Arm, shoulder or hand pain.****
10	Tingling (pins and needles) in your arm, shoulder or hand.****
11	During the past week, how much difficulty have you had sleeping because of the pain in your arm, shoulder or hand?*

Note:

^*Response options for questions 1–6, 11 are 1 = No difficulty; 2 = Mild difficulty; 3 = Moderate difficulty; 4 = Severe difficulty; 5 = So much difficulty that I can’t sleep

^**Response options for question 7 are 1 = Not at all; 2 = Slightly; 3 = Moderately; 4 = Quite a bit; 5 = Extremely

^***Response options for question 8 are 1 = Not limited at all; 2 = Slightly limited; 3 = Moderately limited; 4 = Very limited; 5 = Unable

^****Response options for questions 9–10 are 1 = None; 2 = Mild; 3 = Moderate; 4 = Severe; 5 = Extreme