| Left Time in Se.c Trial 1:_____ Trial 2:_____ | Right Time in Sec. Trial 1: _____ Trial 2:_______ |
| (2) Normal: 20 s. | (2) Normal: 20 s. |
| (1) Moderate: < 20 s. | (1) Moderate: < 20 s. |
| (0) Severe: Unable. | (0) Severe: Unable. |
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