Lower Extremity Functional Index
Today, do you or would you have any difficulty at all with:
Patient Name *
Patient date of birth *
MM
/
DD
/
YYYY
Any of your usual work, housework or school activities. *
Your usual hobbies, recreational or sporting activities *
Getting into or out of the bath. *
Walking between rooms. *
Putting on your shoes or socks. *
Squatting. *
Lifting an object, like a bag of groceries, from the floor. *
Performing light activities around your home. *
Performing heavy activities around your home. *
Getting into or out of a car. *
Walking 2 blocks. *
Walking a mile. *
Going up or down 10 stairs (about 1 flight of stairs). *
Standing for 1 hour. *
Sitting for 1 hour. *
Running on even ground. *
Running on uneven ground. *
Making sharp turns while running fast. *
Hopping. *
Rolling over in bed. *
Source:
Binkley et al (1999): The Lower Extremity Functional Scale (LEFS): Scale development, measurement properties, and
clinical application. Physical Therapy. 79:371-383.
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