Upper Extremity Functional Index (UEFI)
- Fysiobasen
- Sep 17
- 2 min read
The Upper Extremity Functional Index (UEFI) is a validated, self-reported outcome measure designed to assess functional disability in the upper extremities (shoulder, elbow, wrist, and hand) among patients with musculoskeletal disorders¹. It was developed as a simple, time-efficient tool to capture limitations in everyday activities, including household chores, hobbies, driving, lifting, and personal hygiene.
Purpose and clinical use
The main goals of UEFI are to:
Evaluate functional limitations in the upper extremities.
Track changes over time in response to rehabilitation or treatment.
Provide clinicians with a patient-centered perspective on daily activity restrictions.
Serve as an outcome measure in both clinical practice and research.
Target population
UEFI is designed for adults experiencing:
Shoulder, elbow, wrist, or hand injuries.
Chronic musculoskeletal disorders (e.g., arthritis, tendinopathy).
Post-surgical rehabilitation of upper extremities.
Neuromuscular conditions affecting arm function.
It is not condition-specific, making it suitable for a broad range of upper limb pathologies.
Structure of the questionnaire
Items: 20 questions.
Format: Each question is rated on a 5-point Likert scale ranging from 0 (“extreme difficulty / unable to perform”) to 4 (“no difficulty”).
Domains covered: Activities of daily living, mobility, work-related tasks, self-care, and recreation.
Scoring system:
Maximum score = 80 (no disability).
Minimum score = 0 (severe disability).
Higher scores indicate better function and lower disability.
Administration
Time: 5–10 minutes.
Method: Self-administered questionnaire completed by the patient.
Interpretation:
Scores closer to 80 suggest minimal or no disability.
Scores below 50 may indicate significant functional limitation requiring intervention.
Changes of ≥9 points are considered the Minimal Clinically Important Difference (MCID), indicating meaningful improvement.
Psychometric properties
Research has confirmed that UEFI is both reliable and valid:
Reliability:
Test–retest reliability: ICC = 0.95².
High internal consistency (Cronbach’s α = 0.98).
Validity:
Strong correlations with condition-specific instruments (e.g., DASH).
Demonstrates good construct validity across multiple upper extremity disorders³.
Responsiveness:
Sensitive to clinical change over time, making it suitable for treatment monitoring.
Advantages
Short, simple, and easy for patients to complete.
Broad applicability across upper limb conditions.
Provides both baseline assessment and progress monitoring.
Free to use in clinical practice.
Limitations
Does not capture condition-specific symptoms in detail.
May have ceiling effects in high-functioning populations (athletes, young adults).
Best used alongside clinical tests and other patient-reported outcome measures for comprehensive evaluation.
Sources:
Eleftherios Paraskevopoulos, Plakoutsis G, Papandreou M. A Pilot Test of the Measures of the Greek Version of Upper Extremity Functional Index in Patients with Lateral Elbow Tendinopathy. Medical Sciences [Internet]. 2023 Jun 28 [cited 2025 Feb 20];11(3):45–5.
Binkley JM, Stratford P, Kirkpatrick S, Farley CR, Okoli J, Gabram S. Estimating the Reliability and Validity of the Upper Extremity Functional Index in Women After Breast Cancer Surgery. Clinical Breast Cancer. 2018 Dec;18(6):e1261–7.
Alnahdi AH, Albarrati A. The Upper Extremity Functional Index: Reliability and Validity in Patients with Chronic Obstructive Pulmonary Disease. International Journal of Environmental Research and Public Health. 2021 Oct 10;18(20):10608.
Chesworth BM, Hamilton CB, Walton DM, Benoit M, Blake TA, Bredy H, et al. Reliability and Validity of Two Versions of the Upper Extremity Functional Index. Physiotherapy Canada. 2014 Jul;66(3):243–53.
Stratford PW, Binkley JM, Stratford DM. Development and initial validation of the upper extremity functional index. Physiotherapy Can. 2001;53:259–67
