This document discusses several functional outcome measures that can be used by a private physiotherapy clinic to benchmark patient progress, track recovery, and demonstrate the benefits of treatment. It describes the QuickDASH, Lower Extremity Functional Scale, Neck Disability Index, and Back Pain Functional Scale questionnaires. Each measure is scored differently but aims to assess a patient's level of disability or functional ability through self-reported ratings of activities of daily living. The clinic is recommended to have patients complete the appropriate forms at their initial appointment and every 3 weeks to quantitatively track individual progress over 6 weeks of treatment.

1. FUNCTIONAL OUTCOME MEASURES FOR A PRIVATE CLINIC
Why do we needthem?
1. Establishing a benchmark
2. Tracking progress
3. Way to describe disability experienced by the patient
4. Outlines areas of difficulty that can be used as short term goals
5. Demonstrating the benefit of physiotherapy
6. Legal issues
QUICK DASH – DisabilitiesoftheArm, Shoulder,andHand
About
 11 item questionnaire scored between 1-5– shorter version of the DASH that
measures physical functionand symptoms in patients with any or several
musculoskeletal injuries to the upper limb
o MSK includes bone, tendon, ligaments, muscle
 Goal is to describe the disability experienced by the patient and monitor changes in
symptoms and function overtime
 Optional Modules goal is to determine any difficulties that may be experienced that
pertain to specific areas that may have been missed in the original 30 item portion
o Sport/music
o Work
Scoring
 At least 10/11 items must be completed in order to score and 4/4 on optional
modules
 All the scores are summed and averaged and then transformed into a score out of
100 where a higher score indicates greater disability
DASH disability/symptom score = [(
[( 𝑠𝑢𝑚 𝑜𝑓 𝑛 𝑟𝑒𝑠𝑝𝑜𝑛𝑠𝑒𝑠)]
𝑛
) − 1] 𝑥 25
where n is equal to the number of completed responses.
 Online version whichwill score it foryou if needed -
http://www.orthopaedicscore.com/scorepages/disabilities_of_arm_shoulder_hand_
score_quickdash.html
 Excelsheet that can be used to track scores either within a patient or between
patients
LOWER EXTREMITYFUNCTIONSCALE
About
 Self-report, 20-item questionnaire that measures patients initial function,ongoing
progress, and outcome forgeneral lowerextremity conditions
 Intended foruse on adults with lower extremity conditions
 0-4 with 0 representing extreme difficulty or unable to perform activity and 4
representing no difficulty
Scoring:
 Add up all the column totals at the bottom to get a final score out of 80

2.  A higher score indicates high functionand a lower score indicates low function
NECKDISABILITYINDEX
About
 10 items questionnaire that includes the following categories: pain, personal care,
lifting, reading, headaches, concentration,work,driving, sleeping and recreation.
 Specifically forneck pain
 Intended population: chronic neck pain, musculoskeletal neck pain, whiplash
injuries (WAD),and cervicalradiculopathy
Scoring
 Eachitem is ranked 0-5 and the total is added up for a total possible score of 50.
 0-4points (0-8%)no disability,
5-14points (10 – 28%) mild disability,
15-24points (30-48% ) moderate disability,
25-34points (50- 64%) severe disability,
35-50points (70-100%) complete disability
 higher score indicates higher disability
BACKPAIN FUNCTIONALSCALE
About
 self report, 12-item questionnaire to determine functional ability in people with
back pain
 intended population: people with back pain
Scoring
 each item is ranked 0-5 with 0 meaning unable to perform the activity and 5
meaning no difficulty withthe activity
 total of 60- the higher the score the better functionalability the patient has
Recommendations
 Ask patients to arrive 15 min early before their 1stappointment in order to fill out
the appropriate outcomemeasure and then every 3 weeks including the last
appointment
 Use of the ExcelDASH Scoring e-tool or other appropriate outcomemeasure should
be completed to trackindividual patient progress and then printed off at the end of
the 6-week treatment session to demonstrate progress
 FUTURE:downloadthe DASH app and have patients complete it directly on an ipad.

3. REFERENCES
Binkley JM, Stratford PW, Lott SA, Riddle DL. The Lower Extremity Functional Scale
(LEFS): scale development, measurement properties, and clinical application. North
American Orthopaedic Rehabilitation Research Network. Phys Ther. 1999
Apr;79(4):371-83.
Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome
measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The
Upper Extremity Collaborative Group (UECG) Am J Ind Med. 1996 Jun;29(6):602-8.
Erratum in: Am J Ind Med 1996 Sep;30(3):372.
The Institute for Work & Health are the copyright owners of the DASH and
QuickDASH Outcome Measures
Vernon H.& Hagino,C, Neck Disability Index HVERNON@CMCC.CA, 1991
Stratford PW Binkley JM et al. Development and initial validation of the Back Pain
Functional Scale. Spine. 2000; 25: 2095-2102