LEFS

Activities

Usual work, housework, or school activities *

0 Extreme difficulty or unable to perform 1 Quite a bit of difficulty 2 Moderate difficulty 3 A little bit of difficulty 4 No difficulty

Activities

Usual hobbies, recreational or sporting activities *

0 Extreme difficulty or unable to perform 1 Quite a bit of difficulty 2 Moderate difficulty 3 A little bit of difficulty 4 No difficulty

Activities

Getting into or out of the bath *

0 Extreme difficulty or unable to perform 1 Quite a bit of difficulty 2 Moderate difficulty 3 A little bit of difficulty 4 No difficulty

Activities

Walking between rooms *

0 Extreme difficulty or unable to perform 1 Quite a bit of difficulty 2 Moderate difficulty 3 A little bit of difficulty 4 No difficulty

Activities

Putting on shoes or socks *

0 Extreme difficulty or unable to perform 1 Quite a bit of difficulty 2 Moderate difficulty 3 A little bit of difficulty 4 No difficulty

Activities

Squatting *

0 Extreme difficulty or unable to perform 1 Quite a bit of difficulty 2 Moderate difficulty 3 A little bit of difficulty 4 No difficulty

Activities

Lifting an object, like a bag of groceries from the floor *

0 Extreme difficulty or unable to perform 1 Quite a bit of difficulty 2 Moderate difficulty 3 A little bit of difficulty 4 No difficulty

Activities

Performing light activities around your home *

0 Extreme difficulty or unable to perform 1 Quite a bit of difficulty 2 Moderate difficulty 3 A little bit of difficulty 4 No difficulty

Activities

Performing heavy activities around your home *

0 Extreme difficulty or unable to perform 1 Quite a bit of difficulty 2 Moderate difficulty 3 A little bit of difficulty 4 No difficulty

Activities

Getting into or out of a car *

0 Extreme difficulty or unable to perform 1 Quite a bit of difficulty 2 Moderate difficulty 3 A little bit of difficulty 4 No difficulty

Activities

Walking 2 blocks *

0 Extreme difficulty or unable to perform 1 Quite a bit of difficulty 2 Moderate difficulty 3 A little bit of difficulty 4 No difficulty

Activities

Walking a mile *

0 Extreme difficulty or unable to perform 1 Quite a bit of difficulty 2 Moderate difficulty 3 A little bit of difficulty 4 No difficulty

Activities

Going up or down 10 stairs *

0 Extreme difficulty or unable to perform 1 Quite a bit of difficulty 2 Moderate difficulty 3 A little bit of difficulty 4 No difficulty

Activities

Standing for 1 hour *

0 Extreme difficulty or unable to perform 1 Quite a bit of difficulty 2 Moderate difficulty 3 A little bit of difficulty 4 No difficulty

Activities

Sitting for 1 hour *

0 Extreme difficulty or unable to perform 1 Quite a bit of difficulty 2 Moderate difficulty 3 A little bit of difficulty 4 No difficulty

Activities

Running on even ground *

0 Extreme difficulty or unable to perform 1 Quite a bit of difficulty 2 Moderate difficulty 3 A little bit of difficulty 4 No difficulty

Activities

Running on uneven ground *

0 Extreme difficulty or unable to perform 1 Quite a bit of difficulty 2 Moderate difficulty 3 A little bit of difficulty 4 No difficulty

Activities

Making sharp turns while running fast *

0 Extreme difficulty or unable to perform 1 Quite a bit of difficulty 2 Moderate difficulty 3 A little bit of difficulty 4 No difficulty

Activities

Hopping *

0 Extreme difficulty or unable to perform 1 Quite a bit of difficulty 2 Moderate difficulty 3 A little bit of difficulty 4 No difficulty

Activities

Rolling over in bed *

0 Extreme difficulty or unable to perform 1 Quite a bit of difficulty 2 Moderate difficulty 3 A little bit of difficulty 4 No difficulty