Frequency of Orthostatic Symptoms
0 I never or rarely experience orthostatic symptoms when I stand up. 1 I sometimes experience orthostatic symptoms when I stand up. 2 I often experience orthostatic symptoms when I stand up. 3 I usually experience orthostatic symptoms when I stand up. 4 I always experience orthostatic symptoms when I stand up.
Severity of Orthostatic Symptoms
0 I do not experience orthostatic symptoms when I stand up. 1 I experience mild orthostatic symptoms when I stand up. 2 I experience moderate orthostatic symptoms when I stand up and sometimes have to sit back down for relief. 3 I experience severe orthostatic symptoms when I stand up and frequently have to sit back down for relief. 4 I experience severe orthostatic symptoms when I stand up and regularly faint if I do not sit back down.
Conditions under which Orthostatic Symptoms Occur
0 I never or rarely experience orthostatic symptoms under any circumstances. 1 I sometimes experience orthostatic symptoms under certain conditions, such as prolonged standing, a meal, exertion (e.g., walking), or when exposed to heat (e.g., hot day, hot bath, hot shower). 2 I often experience orthostatic symptoms under certain conditions, such as prolonged standing, a meal, exertion (e.g., walking), or when exposed to heat (e.g., hot day, hot bath, hot shower). 3 I usually experience orthostatic symptoms under certain conditions, such as prolonged standing, a meal, exertion (e.g., walking), or when exposed to heat (e.g., hot day, hot bath, hot shower). 4 I always experience orthostatic symptoms when I stand up; the specific conditions do not matter.
Activities of Daily Living
0 My orthostatic symptoms do not interfere with activities of daily living (e.g., work, chores, dressing, bathing). 1 My orthostatic symptoms mildly interfere with activities of daily living (e.g., work, chores, dressing, bathing). 2 My orthostatic symptoms moderately interfere with activities of daily living (e.g., work, chores, dressing, bathing). 3 My orthostatic symptoms severely interfere with activities of daily living (e.g., work, chores, dressing, bathing). 4 My orthostatic symptoms severely interfere with activities of daily living (e.g., work, chores, dressing, bathing). I am bed or wheelchair bound because of my symptoms.
Standing Time
0 On most occasions, I can stand as long as necessary without experiencing orthostatic symptoms. 1 On most occasions, I can stand more than 15 minutes before experiencing orthostatic symptoms. 2 On most occasions, I can stand 5-14 minutes before experiencing orthostatic symptoms. 3 On most occasions, I can stand 1-4 minutes before experiencing orthostatic symptoms. 4 On most occasions, I can stand less than 1 minute before experiencing orthostatic symptoms.
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