1. How much pain are you in at this time? (Questions 2,3,4) How well are you able to perform:
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2. Light activities like walking a block or dressing yourself? |
3. Moderate activities like playing golf, walking half a mile, or dancing? |
4. Vigorous activities like running or moving furniture? |
5. How much is your sleep disturbed by pain at this time? |
6. How well are you able to lift items off the floor at this time? |
7. How would you assess your level of happiness at this time? |
8. How interested are you in socializing at this time? |
9. Because of pain, how much is your socializing limited at this time? |