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PRWE is the Patient Rated Wrist Evaluation.The PRWE is a 15-item questionnaire designed to
measure wrist pain and disability in activities of daily living. Developed in 1998 for clinical
assessment and is used for specific wrist problems.It is one of the reliable upper extremity
outcome intrument.

The PRWE allows patients to rate their levels of wrist pain and disability from 0 to 10, and consists
of 2 subscales:

Pain subscale: it contain 5 items each of which is further rated from 1-10. The maximam
score in this section is 50 and minimum 0


Function subscale: It contain total 10 items which are further divided into 2 sections i.e
specific activities (having 6 items) and usual activities (having 4 items). The maximum
score in this section is 50 and minimum 0.

Development of PRWE
Scale items were generated using information obtained from patient and expert interviews,
biomechanical literature, and other questionnaires.
Items were reduced and refined through expert interviews and pilot testing on small groups of
patients. It Surveyed 100 (66 responded) international wrist investigators (IWIW) to generate
items particularly. After developing the items PRWE was tested.

Testing the PRWE

A test-retest reliability study was conducted on patients with distal radius (n=64) or scaphoid
(n=35) fractures. The total PRWE score
s test-retest reliability was excellent over both the short term (2-7 days, ICC > = 0.90) and the
long term (1 year, ICC = 0.91). The pain subscale also had excellent short-term and long-term
reliability (ICC = 0.90, 0.91, respectively).The function subscale demonstrated excellent short-term
reliability (ICC > = 0.88) and moderate long-term disability (ICC = 0.61).


To determine level of wrist disability

To set treatment goals

To determine whether change has occurred

To communicate in a meaningful way to payers

There are 3 steps to score PRWE
Step 1: Measure the pain score of all 5 items

Step 2: Measure the function score of all the 10 items and divide it by 2

Step 3: Add pain and function score.

Total Score = Sum of pain+ function scores (Best Score = 0, Worst Score = 100)
Less score = better outcome

Merits and Demerits


Developed with patient interviews

Region-specific (wrist) assessment

Short and quick



Validated / developed from fewer centers


No hand dominance

Patient rate wrist/hand evaluation (PRWHE) is the modified version of PRWE. The PRWHE has the
same items and scoring system as the PRWE. The PRWHE is preferred in hand/wrist clinics as it is
more specific and easier to use and also asses the hand along with wrist.
Changes between the PRWE and PRWHE
1) In the PRWHE, the term wrist is replaced with wrist/hand.
2) The PRWHE has an optional aesthetics question on the form (not part of the scale scoring).