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LEFS

This document appears to be a patient assessment form called the Lower Extremity Functional Scale. It contains 20 daily activities and asks patients to rate their ability to perform each activity on a scale from 0 to 4, with 0 being unable to perform and 4 being no difficulty. The total score is calculated by summing the responses, with a minimum detectable change of 9 points out of a possible total of 80. It is used to assess functional limitations in the lower extremities.

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Morteza Bahrami
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51 views1 page

LEFS

This document appears to be a patient assessment form called the Lower Extremity Functional Scale. It contains 20 daily activities and asks patients to rate their ability to perform each activity on a scale from 0 to 4, with 0 being unable to perform and 4 being no difficulty. The total score is calculated by summing the responses, with a minimum detectable change of 9 points out of a possible total of 80. It is used to assess functional limitations in the lower extremities.

Uploaded by

Morteza Bahrami
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Name:___________________________________________ DATE:___________________ DOB:_______________________

THE LOWER EXTREMITY FUNCTIONAL SCALE

We are interested in knowing whether you are having any difficulty at all with the activities listed below because of your lower limb
Problem for which you are currently seeking attention. Please provide an answer for each activity.

Today, do you or would you have any difficulty at all with:

Extreme
Difficulty or Quite a Bit Moderate A Little Bit No
Activities Unable to of Difficulty Difficulty of Difficulty
Perform Activity Difficulty
1 Any of your usual work, housework, or school activities. 0 1 2 3 4
2 Your usual hobbies, re creational or sporting activities. 0 1 2 3 4
3 Getting into or out of the bath. 0 1 2 3 4
4 Walking between rooms. 0 1 2 3 4
5 Putting on your shoes or socks. 0 1 2 3 4
6 Squatting. 0 1 2 3 4
7 Lifting an object, like a bag of groceries from the floor. 0 1 2 3 4
8 Performing light activities around your home. 0 1 2 3 4
9 Performing heavy activities around your home. 0 1 2 3 4
10 Getting into or out of a car. 0 1 2 3 4
11 Walking 2 blocks. 0 1 2 3 4
12 Walking a mile. 0 1 2 3 4
13 Going up or down 10 stairs (about 1 flight of stairs). 0 1 2 3 4
14 Standing for 1 hour. 0 1 2 3 4
15 Sitting for 1 hour. 0 1 2 3 4
16 Running on even ground. 0 1 2 3 4
17 Running on uneven ground. 0 1 2 3 4
18 Making sharp turns while running fast. 0 1 2 3 4
19 Hopping. 0 1 2 3 4
20 Rolling over in bed. 0 1 2 3 4
Column Totals:

Minimum Level of Detectable Change (90% Confidence): 9 points SCORE: _____/ 80


Please submit the sum of responses.
Reprinted from Binkley, J., Stratford, P., Lott, S., Riddle, D., & The North American Orthopaedic Rehabilitation Research Network, The Lower Extremity
Functional Scale: Scale development, measurement properties, and clinical application, Physical Therapy, 1999, 79, 4371-383, with permission of the
American Physical Therapy Association.

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