Template:SPADI: Difference between revisions
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<noinclude>[[Category:Calculators]]</noinclude> | <noinclude>[[Category:Calculators]]</noinclude> |
Revision as of 20:40, 23 March 2023
Pain scale | ||||||||||||
How severe is your pain? | ||||||||||||
Circle the number that best describes your experience where: 0 = no difficulty and 10 = so difficult it requires help. | ||||||||||||
Item | Question | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | At its worst? | |||||||||||
2 | When lying on the involved side? | |||||||||||
3 | Reaching for something on a high shelf? | |||||||||||
4 | Touching the back of your neck? | |||||||||||
5 | Pushing with the involved arm? |
Disability scale | ||||||||||||
How much difficulty do you have? | ||||||||||||
Circle the number that best describes your experience where: 0 = no difficulty and 10 = so difficult it requires help. | ||||||||||||
Item | Question | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
---|---|---|---|---|---|---|---|---|---|---|---|---|
6 | Washing your hair? | |||||||||||
7 | Washing your back? | |||||||||||
8 | Putting on an undershirt or jumper? | |||||||||||
9 | Putting on a shirt that buttons down the front? | |||||||||||
10 | Putting on your pants? | |||||||||||
11 | Placing an object on a high shelf? | |||||||||||
12 | Carrying a heavy object of 4.5 kilograms | |||||||||||
13 | Removing something from your back pocket? |
Pain Score : | Score: 0% | |
---|---|---|
Disability Score : | Score: 0% | |
Total Score : | Score: 0% |