Upper Extremity Functional Index
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The Upper extremity functional index (UEFI) is a patient report outcome measure used to assess functionality in the upper extremities in individuals with upper limb dysfunction of musculoskeletal origin. The original UEFI consists of 20 questions on a 5- point rating scale assessing level of difficulty in performing activities of daily living using the upper extremities.
There are currently two versions of the upper extremity functional index; UEFI 20-item and UEFI 15-item. The 15-item was developed to fit the Rasch analysis and it has been recommended because it's unidimensional. The effect of arm dominance on the positive minimal clinically important difference (pMCID) has not been determined for both versions of UEFI.
The UEFI is intended for use in individuals with upper extremity including the shoulder, elbow, wrist and hand dysfunction of musculoskeletal origin.
Method of Use
The Upper extremity functional index is easy to administer. Patients respond to each item by circling a number that best describes their level of difficulty. Item scores range from 0 to 4, and the total score is a total of the item scores. Possible range 0 – 80 with 0 indicating lowest functional status and 80 indicating highest functional status. The minimum amount of change considered to be clinically significant is 9 points.
In a study by Chesworth et al, reliability for the UEFI-20 and UEFI-15 was the same (ICC=0.94 for both measures). MDC values were 9.4/80 for the UEFI-20 and 8.8/100 for the UEFI-15. Positive minimal clinically important difference values were 8/80 for the UEFI-20 and 6.7/100 for the UEFI-15; pMCID was higher for people whose non-dominant arm was affected.
In a study by Stratford et al, comparing Upper Extremity Functional Index (UEFI 20- item) and the Upper Extremity Functional Scale (UEFS), the discriminant cross-sectional validity of the UEFI was found to be 6.65 with p = .003 while the convergent cross-sectional validity coefficient between the UEFI and the UEFS was 0.82. In the same study, the longitudinal validity coefficient between the UEFI and the UEFS was 0.74. This study concluded that the longitudinal validity of the Upper Extremity Functional Index was superior to the Upper Extremity Functional Scale.
- Stratford PW, Binkley JM, Stratford DM. Development and initial validation of the upper extremity functional index. Physiotherapy Can. 2001;53:259–67
- Liebenson, C. (2007). Rehabilitation of the spine: A practitioner’s manual. Baltimore, MD: Lippincott Williams & Wilkins.
- Chesworth BM, Hamilton CB, Walton DM, et al. Reliability and validity of two versions of the upper extremity functional index. Physiother Can. 2014;66(3):243–253