Download:
pdf |
pdfAttachment 50
PROMIS Pediatric Physical Function Mobility
Context
In the past 7 days
In the past 7 days
In the past 7 days
In the past 7 days
In the past 7 days
In the past 7 days
In the past 7 days
Stem
Responses
I could ride a bike.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
I could get in and out of a car.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
I could walk more than one block.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
I could do sports and exercise that other kids my age could
do.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
I could keep up when I played with other kids.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
I could get out of bed by myself.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
I could get into bed by myself.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
In the past 7 days
In the past 7 days
In the past 7 days
In the past 7 days
In the past 7 days
In the past 7 days
In the past 7 days
I could stand up by myself.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
I could get down on my knees without holding on to
something.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
I could walk up stairs without holding on to anything.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
I used a wheelchair to get around.
4=Never
3=Almost Never
2=Sometimes
1=Often
0=Almost Always
I used a walker, cane or crutches to get around.
4=Never
3=Almost Never
2=Sometimes
1=Often
0=Almost Always
I could carry my books in my backpack.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
I could move my legs.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
In the past 7 days
In the past 7 days
In the past 7 days
In the past 7 days
In the past 7 days
In the past 7 days
In the past 7 days
I could get up from a regular toilet.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
I could get up from the floor.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
I could go up one step.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
I could stand up on my tiptoes.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
I could turn my head all the way to the side.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
I have been physically able to do the activities I enjoy
most.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
I could run a mile.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
In the past 7 days
In the past 7 days
I could bend over to pick something up.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
I could walk across the room.
4=With no trouble
3=With a little trouble
2=With some trouble
1=With a lot of trouble
0=Not able to do
File Type | application/pdf |
File Title | Microsoft Word - Attach 50 PROMIS Pediatric Physical Function Mobility |
Author | Vitali Ustsinovich |
File Modified | 2011-03-23 |
File Created | 2011-03-23 |