Region Specific Instruments

### Headache Impact Test (HIT-6)

The HIT-6TM is a 6-item instrument that was developed using items from previously validated headache disability instruments to measure a wide spectrum of the burden of headache on HRQOL. The instrument addresses the effects of headache on pain, social function, role function, vitality, cognitive function, and psychological distress. The instrument is scored on a range from 36 to 78 with a higher score demonstrating a greater impact of headache on daily life. The scores are further grouped into little or no impact, some impact, substantial impact, and severe impact. Change of 5 or more points is considered a clinically meaningful change and a 3-point change is considered noteworthy. The HIT-6TM is generated for patients who suffer an injury to the head.

### Disabilities of the Arm, Shoulder, and Hand (DASH)

The DASH is a 30-item instrument, which contains separate work and sports/performing arts modules, that measures upper extremity symptoms and disability and serves as a measure of HRQOL. The general scale and the sport module are each scored on a separate 100 point scale, with higher scores indicating greater symptoms and disability and lower HRQOL. The DASH consists of questions that relate to symptoms (e.g., presence of pain and stiffness in your arm, shoulder or hand) and disability (e.g., ability to place an object on a shelf above your head, write, and make your bed). The 4-question sport module measures functional status, which includes questions that relate to disability (e.g., ability to play your musical instrument or sport as well as you would like, and ability to spend your usual amount of time practicing or playing your instrument or sport). The DASH is generated for patients who suffer from an injury to the upper extremity.

### Lower Extremity Functional Scale (LEFS)

The LEFS is a 20-item instrument that evaluates function in people with a variety of lower extremity orthopedic conditions and is useful as both a clinical and research tool. Scores on the LEFS range from 0-80, with higher scores indicative of better functional status. The LEFS is generated for patients with injury to the hip or thigh. It can also be manually added on the Injury Demographic form.

### International Knee Documentation Committee Knee Form (IKDC)

The IKDC is a reliable and valid 18 item outcomes instrument used for evaluating the symptoms, function, and sports activity in people with a variety of knee conditions or injuries including ligament, meniscal, and cartilage injuries and osteoarthritis and patellofemoral pain. Scores on the IKDC range from 0-100, with higher scores indicative of better function and sports activity. A change of 13 IKDC scale points is indicative of both true changes in patient status and is likely to be perceived as meaningful by patients. The IKDC is generated for patients suffering an injury to the knee.

### Functional Ankle Ability Measure (FAAM)

The FAAM is a modified version of the Foot and Ankle Disability Index (FADI) and was created as a comprehensive evaluation tool for people with a variety of lower leg, foot, and ankle musculoskeletal disorders. Scoring for the FAAM is based on two sub-scales, with one Activities of Daily Living (ADL) (21 questions) and the other related to sports activities (8 questions). The ADL sub-scale is scored from 0- 84 and the Sports Module is scored from 0-32, with higher scores indicating higher ability level. The FAAM is generated for patients suffering from a lower leg, ankle, foot, or toe injury.

### Modified Oswestry Low Back Disability Questionnaire (MOSW)

The MOSW is a 10-item region specific self-report instrument aimed at evaluating function in people with low back pain. Scoring is based on a 0-5 Likert scale, with higher scores indicative of greater disability. The MOSW is generated for patients suffering an injury to the back or trunk.

### Patient Specific Functional Scale (PSFS)

In addition to the general and specific outcomes instruments, the EMR system includes the PSFS, which is an instrument that allows for measuring change in a single patient’s status over time. To complete the PSFS, patients identify 3-5 functional tasks that are difficult to complete as a result of their injury and these items are evaluated at the beginning and end of care. The PSFS is an optional scale that must be added on the Injury Demographic form. Items indicated by the patient on the PSFS are automatically entered into the Injury Evaluation as patient specific goals.

We highly recommend utilizing this patient-centered outcomes instrument with all of your patients.