Patient Specific Functional Scale

Patient or caregiver identifies 3 areas of  functional difficulties (ex. sit to stand, indoor balance, indoor walking) and rates their ability to perform identified activity  (0-10 or 0%-100%). 

Short Falls Efficacy Scale International (Short FES-I)

Assesses concerns about falling relating to 7 basic activities:  dressing, bathing, sit to stand, car transfers, reaching,  stairs, slopes, and getting out.

Activities-specific Balance Confidence Scale (ABC-6)

Assesses balance confidence in 6 difficult situations active community dwelling older adults may encounter, including:  tip toe reaching, standing on a chair, being bumped, using an escalator, and walking on ice.

Neck Disability Index

Assesses ADLs in persons with neck pain including:  lifting, sleeping, headaches, reading, etc.

This can also be filled out in Medigraph:  Outcome Questionnaires>Head/Spine>Neck Disability

QuickDASH (Arm, shoulder, hand)

11 Self rated items measuring physical function, activities, and symptoms involving single or multiple disorders of the upper extremities.  Assessment includes ADLs, pain, and N/T.

Modified Oswestry LBP

Measures activities in persons with back pain including: pain intensity, personal care, lifting, sleeping, sitting, standing, walking, traveling, working, and social life.

This can also be filled out in Medigraph:  Outcome Questionnaires>Head/Spine>Oswestry (Modified)

Lower Extremity Functional Scale

20 everyday items from lifting groceries to turning over in bed.  It can be used by clinicians as a measure of initial function, ongoing progress, and outcome and to set functional goals.  It is applicable to a wide range of disability levels and conditions and all lower-extremity sites. It is a self-report condition-specific measure and is reliable and valid.

QUESTIONNAIRES