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. 2012 Dec 28;6:156–162. doi: 10.2174/1874192401206010156

Table 2.

Questions Coding for Physical Capacity and Physical Activity, with Response Options

Physical Capacity
The following questions concern your physical capacity. For each activity circle the answer that best applies to you. Here we would like you to evaluate your physical capacity over the past few weeks.
1. “Walking at normal speed on level ground”
2. “Walking at normal speed uphill or up stairs”
3. “Walking quickly uphill or up stairs”
4. “Running slowly uphill or up stairs, or running on level ground”
1 not at all 2 not very well 3 with a little difficulty 4 not sure 5 a little 6 quite well 7 very well*
Physical activity
The following questions concern how much you exercise/or are physically active.
5. “How do you evaluate your present physical activity compared with other people your age?”
6. “How much have you exercised this year compared to last year?”
1 much less exercise 2 less exercise 3 a little less exercise 4 average exercise 5 a little more exercise 6 more exercise 7 much more exercise*
7. “How often do you exercise?”
1 never 2 less than once a week 3 once a week 4 two or three times a week 5 almost every day
8. “How hard do you exercise?”
1 I take it easy without getting breathless and sweaty 2 I get a little breathless and sweaty 3 I definitely get breathless and sweaty 4 I am almost totally exhausted
 9. “How long do you exercise each time?”
1 less than 15 minutes 2 16 to 30 minutes 3 31 minutes to 1 hour 4 More than 1 hour
*

Answer options are identical for the questions above