Neck Disability Index Questionnaire - Clinical Health Services

Neck Disability Index Questionnaire - Clinical Health Services - 2007 Page 2

NECK DISABILITY INDEX QUESTIONNAIRE

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Section 4- Reading

I can read as much as I want to with no pain in my neck.

I can read as much as I want to with slight pain in my neck.

I can read as much as I want to with moderate pain in my neck.

I cannot read as much as I want because of moderate pain in my neck.

I cannot read as much as I want because of severe pain in my neck.

I cannot read at all.

Section 5- Headaches

I have no headaches at all.

I have slight headaches which come infrequently.

I have moderate headaches which come infrequently.

I have moderate headaches which come frequently.

I have severe headaches which come frequently.

I have headaches almost all the time.

Section 6- Concentration

I can concentrate fully when I want to with no difficulty.

I can concentrate fully when I want to with slight difficulty.

I have a fair degree of difficulty in concentrating when I want to.

I have a lot of difficulty in concentrating when I want to.

I have a great deal of difficulty in concentrating when I want to.

I cannot concentrate at all.

Section 7- Work

I can do as much work as I want to.

I can only do my usual work, but no more.

I can do most of my usual work, but no more.

I cannot do my usual work.

I can hardly do any work at all.

I cannot do any work at all.

Section 8- Driving

I can drive my car without any neck pain.

I can drive my car as long as I want with slight pain in my neck.

I can drive my car as long as I want with moderate pain in my neck.

I cannot drive my car as long as I want because of moderate pain in my neck.

I can hardly drive at all because of severe pain in my neck.

I cannot drive my car at all.

8/2/2007

Neck Disability Index Questionnaire - Clinical Health Services - 2007 Page 2