PRTEE Outcome Measure: Scoring Formula, Pain Subscale and Lateral Epicondylalgia
In short
The Patient-Rated Tennis Elbow Evaluation (PRTEE) is the definitive outcome measure for lateral elbow tendinopathy. Learn how to calculate scores, interpret results and apply MCID.
In this guide (4 sections)
What Is the Patient-Rated Tennis Elbow Evaluation (PRTEE)?
The Patient-Rated Tennis Elbow Evaluation (PRTEE), formerly known as the Patient-Rated Forearm Evaluation Questionnaire (PRFEQ), was developed by Joy MacDermid in 1999.
It is the most sensitive and condition-specific self-report measure for lateral epicondylalgia (tennis elbow), evaluating forearm pain and functional disability.
Structure: Pain and Function Subscales
The questionnaire consists of 15 items scored on an 11-point numeric scale from 0 (no pain / no difficulty) to 10 (worst imaginable pain / unable to do).
The instrument is divided into two distinct subscales: Pain (5 items) and Function (10 items, split into 6 specific activities and 4 usual daily activities).
| Subscale | Number of Items | Scale Range | Clinical Tasks Assessed | |
|---|---|---|---|---|
| Pain Subscale | 5 items | 0 to 50 points | Pain at rest, carrying heavy bag, gripping a tool, wrist extension against resistance, worst overall pain. | |
| Specific Activities | 6 items | 0 to 60 points | Turning doorknob, carrying 5 kg bag, opening tight jar, using wrench/knife, pulling car door, recreational sports. | |
| Usual Activities | 4 items | 0 to 40 points | Personal care (dressing, washing), household work, occupation/work tasks, recreational activities. | |
| Function Subscale Total | 10 items | 0 to 100 points | Sum of Specific (60) + Usual (40) points. |
Calculation Formula and 0 to 100 Index
To ensure that pain and function contribute equally to the final score (50 percent each), the function subscale sum is divided by 2:
Total PRTEE Score = Pain Subscale Sum (out of 50) + [Function Subscale Sum (out of 100) / 2].
The final score ranges from 0 (no pain, perfect function) to 100 (extreme pain, complete disability).
- Minimal Clinically Important Difference (MCID): Polkinghorne et al. established an MCID of 11 points (or a 37% reduction from baseline).
- Mild Impairment: Scores under 20 points (patient experiences mild soreness after heavy vocational load).
- Moderate Impairment: Scores between 20 and 40 points (interferes with lifting grocery bags, wringing clothes or keyboarding).
- Severe Impairment: Scores above 50 points (unable to lift a coffee cup or turn a door key without acute lateral elbow pain).
Frequently Asked Questions
Why is PRTEE preferred over DASH for tennis elbow?
PRTEE has significantly higher sensitivity to change for lateral epicondylalgia than general upper extremity scales like DASH, showing no floor or ceiling effect.
What if a patient leaves an item blank on the PRTEE?
If 1 item in the pain subscale or up to 2 items in the function subscale are missed, calculate the mean of the completed items in that section and replace the missing values.
How does PRTEE correlate with pain-free grip strength?
PRTEE scores correlate strongly (r = -0.65 to -0.72) with dynamometer pain-free grip strength: as PRTEE scores drop, grip capacity increases.
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