Table 1.

Patient self-evaluation: activities of daily living questionnaire^a.

Activity	Right arm	Left arm
1. Put on a coat	0 1 2 3	0 1 2 3
2. Sleep on your painful or affected side	0 1 2 3	0 1 2 3
3. Wash back/do up bra in the back	0 1 2 3	0 1 2 3
4. Manage toileting	0 1 2 3	0 1 2 3
5. Comb hair	0 1 2 3	0 1 2 3
6. Reach a high shelf	0 1 2 3	0 1 2 3
7. Lift 10 pounds above shoulder	0 1 2 3	0 1 2 3
8. Throw a ball overhand	0 1 2 3	0 1 2 3
9. Do usual work. List:	0 1 2 3	0 1 2 3
10. Do usual sport. List:	0 1 2 3	0 1 2 3

^aPatients circle the number in the box that indicates their ability to do the activity listed: 0=Unable to do; 1=Very difficult to do; 2=Somewhat difficult; 3=Not difficult.