Date of completion
Michigan Hand Outcome Questionnaire    
Clinician's name (or ref) Patient's name (or ref)
Patient's d.o.b
 
Please answer the following 37 multiple choice questions.  
The following questions refer to the function of your hand(s) and/or wrist(s) during the past week....  
1. Overall how well did your hand work?   20.How often did yo have to take it easy at your work because of problems with your hand(s) or wrist(s)?
very good   always
good   often
fair   sometimes
poor   rarely
very poor   never
     
2. How well did your fingers move?   21. How often did you accomplish less in your work because of problems with your hand(s) or wrist(s)?
very good   always
good   often
fair   sometimes
poor   rarely
very poor   never
     
3. How well did your wrist move?   22. How often did you take longer to do the tasks in your work because of problems with your hand(s) or wrist(s)?
very good   always
good   often
fair   sometimes
poor   rarely
very poor   never
     
4. How was the strength in your hand?   23. How often did you have pain in your hand(s) and/or wrists(s)?
very good   always
good   often
fair   sometimes
poor   rarely
very poor   never
     
5. How was the sensation (feeling) in your hand?   24. Please describe the pain you have in your hand(s) and/or wrists(s)?
very good   very mild
good   mild
fair   moderate
poor   severe
very poor   very severe
     
6. Turn a door knob.   25. How often did the pain in your hand(s) and/or wrists(s) interfere with your sleep?
not at all difficult   always
a little difficult   often
somewhat difficult   sometimes
moderately difficul   rarely
very difficult   never
     
7. Pick up a coin.   26. How often did the pain in your hand(s) and/or wrists(s) interfere with your daily activities (such as eating or bathing?
not at all difficult   always
a little difficult   often
somewhat difficult   Some nights
moderately difficul   rarely
very difficult   never
     
8. Hold a glass of water.   27. How often did the pain in your hand(s) and/or wrists(s) make you unhappy?
not at all difficult   always
a little difficult   often
somewhat difficult   sometimes
moderately difficul   rarely
very difficult   never
     
9. Turn a key in the lock.   28. I was satisfied with the appearance (look) of my hand.
not at all difficult   strongly agree
a little difficult   agree
somewhat difficult   neither agree nor disagree
moderately difficul   disagree
very difficult   strongly disagree
     
10. Hold a frying pan.   29. The appearance (look) of my hand sometimes made me uncomfortable in public.
not at all difficult   strongly agree
a little difficult   agree
somewhat difficult   neither agree nor disagree
moderately difficul   disagree
very difficult   strongly disagree
     
11. Open a jar..   30. The appearance (look) of my hand made me depressed.
not at all difficult   strongly agree
a little difficult   agree
somewhat difficult   neither agree nor disagree
moderately difficul   disagree
very difficult   strongly disagree
     
12. Button a shirt or blouse.   31. The appearance (look) of my hand interfered with my normal social activities.
not at all difficult   strongly agree
a little difficult   agree
somewhat difficult   neither agree nor disagree
moderately difficul   disagree
very difficult   strongly disagree
     
13. Eat with a knife and fork.   32. Overall function of your hand?
not at all difficult   very satisfied
a little difficult   somewhat satisfied
somewhat difficult   neither satisfied nor dissatisfied
moderately difficul   somewhat dissatisfied
very difficult   very dissatisfied
     
14. Carry a grocery bag.   33. Motion of the fingers in your hand?
not at all difficult   very satisfied
a little difficult   somewhat satisfied
somewhat difficult   neither satisfied nor dissatisfied
moderately difficul   somewhat dissatisfied
very difficult   very dissatisfied
     
15.Wash dishes.   34. Motion of your wrist?
not at all difficult   very satisfied
a little difficult   somewhat satisfied
somewhat difficult   neither satisfied nor dissatisfied
moderately difficul   somewhat dissatisfied
very difficult   very dissatisfied
     
16. Wash your hair.   35. Strength level of your hand?
not at all difficult   very satisfied
a little difficult   somewhat satisfied
somewhat difficult   neither satisfied nor dissatisfied
moderately difficul   somewhat dissatisfied
very difficult   very dissatisfied
     
17. Tie shoelaces or knots   36. Pain level of your hand?
not at all difficult   very satisfied
a little difficult   somewhat satisfied
somewhat difficult   neither satisfied nor dissatisfied
moderately difficul   somewhat dissatisfied
very difficult   very dissatisfied
     
18. How often were you unable to do your work because of problems with your hand(s) and/or wrist(s)?   37. Sensation (feeling) of your hand?
always   very satisfied
often   somewhat satisfied
sometimes   neither satisfied nor dissatisfied
rarely   somewhat dissatisfied
never   very dissatisfied
     
19. How often did you have to shorten your work day because of problems with your hand(s)?    
always      
often      
sometimes      
rarely      
never      

To save this data please print or

 
General Score is: %
Work Score is: %
Pain Score is: %
Appearance Score is: %
Final Score is: %
Michigan Hand Outcome Score is: %
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