quickdash
INSTRUCTIONS

Ce questionnaire porte sur vos symptômes ainsi que votre capacité à effectuer certaines activités. S'il vous plaît répondre à chaque question, en fonction de votre état ​​dans la dernière semaine, en cliquant sur le numéro approprié. Si vous n'avez pas eu l'occasion d'exercer une activité dans la semaine écoulée, s'il vous plaît faire votre meilleure estimation de la réponse qui serait le plus précis. Il n'est pas question que la main ou le bras que vous utilisez pour effectuer l'activité, s'il vous plaît réponse en fonction de votre capacité indépendamment de la façon dont vous effectuez la tâche.

Aucune difficulté Difficulté légère Difficulté moyenne Difficulté importante Impossible
1. Dévisser un couvercle serré ou neuf.   Warning: Undefined array key "rad1" in /home/h398/drgasiunas.com/wp-content/themes/drgasiunas/quickdash_fr_new.php on line 860
>1
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>2
Warning: Undefined array key "rad1" in /home/h398/drgasiunas.com/wp-content/themes/drgasiunas/quickdash_fr_new.php on line 862
>3
Warning: Undefined array key "rad1" in /home/h398/drgasiunas.com/wp-content/themes/drgasiunas/quickdash_fr_new.php on line 863
>4
Warning: Undefined array key "rad1" in /home/h398/drgasiunas.com/wp-content/themes/drgasiunas/quickdash_fr_new.php on line 864
>5
2. Effectuer des tâches ménagères lourdes (nettoyage des sols ou des murs). Warning: Undefined array key "rad2" in /home/h398/drgasiunas.com/wp-content/themes/drgasiunas/quickdash_fr_new.php on line 869
>1
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>2
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>3
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>4
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>5
3. Porter des sacs de provisions ou une mallette. Warning: Undefined array key "rad3" in /home/h398/drgasiunas.com/wp-content/themes/drgasiunas/quickdash_fr_new.php on line 878
>1
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>2
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>3
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>4
Warning: Undefined array key "rad3" in /home/h398/drgasiunas.com/wp-content/themes/drgasiunas/quickdash_fr_new.php on line 882
>5
4. Se laver le dos. Warning: Undefined array key "rad4" in /home/h398/drgasiunas.com/wp-content/themes/drgasiunas/quickdash_fr_new.php on line 887
>1
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>2
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>3
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>4
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>5
5. Couper la nourriture avec un couteau. Warning: Undefined array key "rad5" in /home/h398/drgasiunas.com/wp-content/themes/drgasiunas/quickdash_fr_new.php on line 896
>1
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>2
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>3
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>4
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>5
6. Activités de loisir nécessitant une certaine force ou avec des chocs au niveau de l'épaule du bras ou de la main. (bricolage, tennis, golf, etc..). Warning: Undefined array key "rad6" in /home/h398/drgasiunas.com/wp-content/themes/drgasiunas/quickdash_fr_new.php on line 905
>1
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>2
Warning: Undefined array key "rad6" in /home/h398/drgasiunas.com/wp-content/themes/drgasiunas/quickdash_fr_new.php on line 907
>3
Warning: Undefined array key "rad6" in /home/h398/drgasiunas.com/wp-content/themes/drgasiunas/quickdash_fr_new.php on line 908
>4
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>5
Pas du tout Légèrement Moyennement Beaucoup Extrêmement
7. Pendant les 7 derniers jours, à quel point votre épaule, votre bras ou votre main vous a-t-elle gêné dans vos relations avec votre famille, vos amis ou vos voisins ? (entourez une seule réponse)?   Warning: Undefined array key "rad7" in /home/h398/drgasiunas.com/wp-content/themes/drgasiunas/quickdash_fr_new.php on line 943
>1
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>2
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>3
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>4
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>5
Pas du tout limité Légèrement limité Moyennement limité Très limité Incapable
8. Avez-vous été limité dans votre travail ou une de vos activités quotidiennes habituelles en raison de problèmes à votre épaule, votre bras ou votre main?   Warning: Undefined array key "rad8" in /home/h398/drgasiunas.com/wp-content/themes/drgasiunas/quickdash_fr_new.php on line 984
>1
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>2
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>3
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>4
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>5
Aucune Légère Moyenne Importante Extrême
9. Douleur de l'épaule, du bras ou de la main.   Warning: Undefined array key "rad9" in /home/h398/drgasiunas.com/wp-content/themes/drgasiunas/quickdash_fr_new.php on line 1022
>1
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>2
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>3
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>4
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>5
10. Picotements ou fourmillements douloureux de l'épaule, du bras ou de la main. Warning: Undefined array key "rad10" in /home/h398/drgasiunas.com/wp-content/themes/drgasiunas/quickdash_fr_new.php on line 1031
>1
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>2
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>3
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>4
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>5
Pas du tout perturbé Un peu perturbé Moyennement perturbé Très perturbé Tellement perturbé que je ne peux pas dormir
11. Pendant les 7 derniers jours, votre sommeil a-t-il été perturbé par une douleur de votre épaule, de votre bras ou de votre main ? (entourez une seule réponse)?   Warning: Undefined array key "rad11" in /home/h398/drgasiunas.com/wp-content/themes/drgasiunas/quickdash_fr_new.php on line 1071
>1
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>2
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>3
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>4
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>5

Quel est votre niveau de satisfaction:


  • 0 – pas du tout satisfait(e)
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10 très satisfait(e)





5,442 Des vues