Table 1.
Screen for musculoskeletal impairment | Yes | No |
1. Is any part of your body missing or misshapen? | ○ | ○ |
2. Do you have any difficulty using your arms? | ○ | ○ |
3. Do you have any difficulty using your legs? | ○ | ○ |
4. Do you have any difficulty using any other part of your body? | ○ | ○ |
5. Do you need a mobility aid or prosthesis? | ○ | ○ |
6. Do you have convulsions, involuntary movement, rigidity or loss of consciousness? | ○ | ○ |
If any of the answers are "yes" | ||
7. Has it lasted more than one month or is it permanent? | ○ | ○ |