| 1. Subjective symptoms (9 points) |
| a. Low back pain: None (3), occasional mild pain (2), frequent mild or occasional severe pain (1), frequent or continuous severe pain (0) |
| b. Leg pain and/or tingling: None (3), occasional slight symptom (2), frequent slight or occasional severe symptom (1), frequent or continuous severe symptom (0) |
| c. Walking capacity: Normal (3), Able to walk further than 500 metres although it results in pain, tingling and /or muscle weakness (2) Unable to walk further than 500 metres owing to leg pain, tingling and/or muscle weakness (1), Unable to walk further than 100 metres owing to leg pain, tingling and/or muscle weakness (0) |
| 2. Objective findings (6 points) |
| a. SLR tests: Normal (2), 30° to 70° (1), < 30° (0) |
| b. Sensory disturbance: None (2), slight disturbance (1), marked disturbance (0) |
| c. Motor disturbance: Normal (grade 5) (2), slight weakness (grade 4) (1), marked weakness (grade 3) (0) |
| 3. Restriction of ADL (14 points) |
| Turn over while lying, standing, washing the face, leaning forwards, sitting (about one hour), lifting or holding heavy objects, walking: No restriction (2), moderate restriction (1), severe restriction (0) for each item |
| 4. Bladder function (-6 points) |
| Normal (0), mild dysuria (-3), severe dysuria (-6) |
