Upper Extremity Functional Index (UEFI)

Assesses the functional impairment caused by upper limb disability and pain.

You can find more information about the model and its interpretation in the text below the calculator.

The UEFI evaluates how much impact the upper limb disability degree and pain have on the performing of activities of daily living in patients with a diagnosed impairment of the shoulder, elbow, wrist or hand.

Each of the 20 activities from the index is awarded a number of points, depending on how difficult to perform the subject perceives that activity.

The final UEFI score ranges between 0 and 80 points. Scores closer to 0 indicate severe limitation whilst scores closer to 80 indicate very little to no limitation.

The significant change between two subsequent evaluation is set at 9 points.

Today, do you or would you have any difficulty at all with:

1Any of your usual work, housework, or school activities
2Your usual hobbies, recreational or sporting activities
3Lifting a bag of groceries to waist level
4Lifting a bag of groceries above your head
5Grooming your hair
6Pushing up on your hands (eg, from bathtub or chair)
7Preparing food (eg, peeling, cutting)
9Vacuuming, sweeping or raking
11Doing up buttons
12Using tools or appliances
13Opening doors
15Tying or lacing shoes
17Laundering clothes (eg, washing, ironing, folding)
18Opening a jar
19Throwing a ball
20Carrying a small suitcase with your affected limb
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UEFI explained

The upper extremity functional index evaluates the impairment the subject perceives they encounter when performing 20 types of activities of daily living. The UEFI is addressed to patients diagnosed with orthopaedic conditions that affect the upper limb (shoulder, elbow, wrist or hand).

The following instruction needs to be provided before the questionnaire is administered:

“We are interested in knowing whether you are having any difficulty at all with the activities listed below because of your upper limb problem for which you are currently seeking attention. Please provide an answer for each activity.

Today, do you or would you have any difficulty at all with:”

The 20 activities included in the UEFI are listed in the following table:

1. Any of your usual work, housework, or school activities;
2. Your usual hobbies, recreational or sporting activities;
3. Lifting a bag of groceries to waist level;
4. Lifting a bag of groceries above your head;
5. Grooming your hair;
6. Pushing up on your hands (eg, from bathtub or chair);
7. Preparing food (eg, peeling, cutting);
8. Driving;
9. Vacuuming, sweeping or raking;
10. Dressing;
11. Doing up buttons;
12. Using tools or appliances;
13. Opening doors;
14. Cleaning;
15. Tying or lacing shoes;
16. Sleeping;
17. Laundering clothes (eg, washing, ironing, folding);
18. Opening a jar;
19. Throwing a ball;
20. Carrying a small suitcase with your affected limb.

There are other similar disability and pain evaluation questionnaires that evaluate the quality of life, such as the Shoulder Pain And Disability Index (SPADI) or the Expanded Disability Status Scale (EDSS).


Result interpretation

Each of the 20 actions in the UEFI is evaluated on a 5-point scale that refers to the perceived difficulty in performing the mentioned action:

■ Extreme difficulty or unable to perform activity (0 points);

■ Quite a bit of difficulty (1 point);

■ Moderate difficulty (2 points);

■ A little bit of difficulty (3 points);

■ No difficulty (4 points).

The overall UEFI result ranges between 0 and 80, where 0 indicates most severe limitation and 80 suggests least limitation.

The UEFI model does not provide any specific cut off points that could classify the upper limb disability degree, however, a minimal detectable change of 9 points is provided.

This means that for improvement or deterioration to be considered, between two subsequent evaluations, the scores must differ by at least 9 points.


Strengths and weaknesses of the model

The UEFI is based on a 2001 study by Stratford et al. and allows a simple identification of the level of functional impairment patients with upper limb ortopedic conditions suffer from. The index is easy to administer and to score.

The test-retest reliability coefficient was found to be 0.95 with an internal consistency of 0.94. The UEFI has also been validated in numerous studies.

On the other hand, the UEFI has been criticised for failing to provide insight into the underlying cause of difficulties encountered in specific actions and the fact that it does not offer an exhaustive severity classification.

Some of the activities in the index were also deemed to be too broad. The index is said to encourage both patient and assessor subjectivity, the first because the index is self-report and depends on patient perception of said difficulties and the second because of the lack of severity cut-offs.


Original source

Stratford P, Binkley J, Stratford D. Development and initial validation of the upper extremity functional index. Physiotherapy Canada. 2001; 53(4):259-67.


Chesworth BM et al. Reliability and Validity of Two Versions of the Upper Extremity Functional Index. Physiother Can. 2014; 66(3): 243–253.

Other references

1. Liebenson C. (2007) Rehabilitation of the spine: A practitioner’s manual. Baltimore, MD: Lippincott Williams & Wilkins.

2. Gabel CP, Michener LA, Burkett B, Neller A. The Upper Limb Functional Index: development and determination of reliability, validity, and responsiveness. J Hand Ther. 2006; 19(3):328-48; quiz 349.

Specialty: Disability

Objective: Evaluation

Type: Index

No. Of Items: 20

Year Of Study: 2001

Abbreviation: UEFI

Published On: July 16, 2017

Last Checked: July 16, 2017

Next Review: July 16, 2023