Patient selection: multiple sclerosis
Time interval: past 2 weeks
Impact from multiple sclerosis:
(1) limited the ability to walk
(2) limited the ability to run
(3) limited the ability to use the stairs
(4) made standing more difficult
(5) affected balance while walking or standing
(6) limited walking distance
(7) increased the effort needed to walk
(8) needed a support when walking indoors
(9) needed a support when walking outdoors
(10) slowed down walking pace
(11) affected the smoothness of walking
(12) required concentration to walk
|
Response
|
Points
|
|
not at all
|
1
|
|
a little
|
2
|
|
moderately
|
3
|
|
quite a bit
|
4
|
|
extremely
|
5
|
score =
= SUM(points for all 12 responses)
Interpretation:
• minimum score: 12
• maximum score: 60
