Oxford Score - Shoulder

Oxford Score - Shoulder

Please answer the questions as they relate to the past four (4) weeks
Shoulder*

LeftRight
Name*

First NameLast Name
How would you describe the worst pain you had from your shoulder?*

NoneMildModerateSevereUnbearable
Have you had any trouble dressing yourself because of your shoulder?*

No trouble at allA little bit of troubleModerate troubleExtreme difficultyImpossible to do
Have you had any trouble getting in and out of a car or using public transport because of your shoulder?*

No trouble at allA little bit of troubleModerate troubleExtreme difficultyImpossible to do
Have you been able to use a knife and fork at the same time?*

Yes, easilyWith little difficultyWith moderate difficultyWith extreme difficultyNo, impossible
Could you do household shopping on your own?*

Yes, easilyWith little difficultyWith moderate difficultyWith extreme difficultyNo, impossible
Could you carry a tray containing a plate of food across a room?*

Yes, easilyWith little difficultyWith moderate difficultyWith extreme difficultyNo, impossible
Could you comb/brush your hair with the affected arm?*

Yes, easilyWith little difficultyWith moderate difficultyWith extreme difficultyNo, impossible
How would you describe the pain you usually had from your shoulder?*

NoneVery mildMildModerateSevere
Could you hang your clothes up in a wardrobe using your affected arm?*

Yes, easilyWith little difficultyWith moderate difficultyWith extreme difficultyNo, impossible
Have you been able to wash and dry yourself under both arms?*

Yes, easilyWith little difficultyWith moderate difficultyWith extreme difficultyNo, impossible
How much has pain from your shoulder interfered with your usual work? Including housework*

Not at allA little bitModeratelyGreatlyTotally
Have you been troubled by pain from your shoulder in bed at night?*

No nightsOnly 1 - 2 nightsSome nightsMost nightsEvery night
Should be Empty: