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Date of completion

The Disabilities of the Arm, Shoulder and Hand (DASH)-Sports/Performing Arts Module

Clinician's name (or ref)
Patient's name (or ref
 

The following questions relate to the impact of your arm, shoulder or hand problem on playing your musical instrument or sport or both. If you play more than one sport or instrument (or play both), please answer with respect to that activity which is most important to you.

Do you play a sport or musical instrument?
 
No (You may skip this section)
Yes Please indicate the sport or instrument which is most important to you  
 
Select which best describes your physical ability in the past week. Did you have any difficulty.....
No difficulty

Mild difficulty

Moderate difficulty
Severe difficulty
Unable
1.
Using your usual technique for playing your instrument or sport?
2.

Playing your musical instrument or sport because of your arm, shoulder or hand pain?
3.

Playing your musical instrument or sport as well as you would like?
4.

Spending your usual amount of time practising or playing your instrument or sport?
Nb: This page cannot be saved due to patient data protection so please print the filled in form before closing the window.
 

The Disabilies of the Arm, Shoulder and Hand (DASH) Score - Sports/Performing Arts Module Score is  

This score may not be calculated if there are any missing items.

Reference for Score: 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 (http://www.dash.iwh.on.ca/)