Table 3.
1. No difficulty | 2. Some difficulty | 3. A lot of difficulty | 4. Completely unable | 5. Do not know | |
---|---|---|---|---|---|
Mobility: Lower body | |||||
Walking one quarter-mile | ○ | ○ | ○ | ○ | ○ |
Walking up 10 steps | ○ | ○ | ○ | ○ | ○ |
Standing 20 minutes | ○ | ○ | ○ | ○ | ○ |
Lifting 10 pounds | ○ | ○ | ○ | ○ | ○ |
Bending down from a standing position to pick up an object from the floor | ○ | ○ | ○ | ○ | ○ |
Mobility: Hand use | |||||
Grasp handle | ○ | ○ | ○ | ○ | ○ |
Hold pen | ○ | ○ | ○ | ○ | ○ |
Mobility: Arm use | |||||
Reaching | ○ | ○ | ○ | ○ | ○ |
Self-care | |||||
Getting to and using toilet | ○ | ○ | ○ | ○ | ○ |
Getting in and out of chairs/bed | ○ | ○ | ○ | ○ | ○ |
Moving inside home | ○ | ○ | ○ | ○ | ○ |
Dressing | ○ | ○ | ○ | ○ | ○ |
Eating | ○ | ○ | ○ | ○ | ○ |
Bathing or showering | ○ | ○ | ○ | ○ | ○ |
Domestic life—Light | |||||
Managing money | ○ | ○ | ○ | ○ | ○ |
Preparing meals | ○ | ○ | ○ | ○ | ○ |
Shopping | ○ | ○ | ○ | ○ | ○ |
Light housework | ○ | ○ | ○ | ○ | ○ |
Domestic life—Heavy | |||||
Heavy housework | ○ | ○ | ○ | ○ | ○ |