Can you: | Without ANY Difficulty | With SOME Difficulty | With MUCH Difficulty | Unable To Do |
---|---|---|---|---|
Dress, including tying shoelaces | â–¡ | â–¡ | â–¡ | â–¡ |
Shampoo your hair | â–¡ | â–¡ | â–¡ | â–¡ |
Stand up from a straight chair | â–¡ | â–¡ | â–¡ | â–¡ |
Get in and out of bed | â–¡ | â–¡ | â–¡ | â–¡ |
Cut your meat | â–¡ | â–¡ | â–¡ | â–¡ |
Lift a full cup or glass to your mouth | â–¡ | â–¡ | â–¡ | â–¡ |
Open a new milk carton | â–¡ | â–¡ | â–¡ | â–¡ |
Walk outdoors on flat ground | â–¡ | â–¡ | â–¡ | â–¡ |
Climb up five steps | â–¡ | â–¡ | â–¡ | â–¡ |
Wash and dry your body | â–¡ | â–¡ | â–¡ | â–¡ |
Take a tub bath | â–¡ | â–¡ | â–¡ | â–¡ |
Get on and off the toilet | â–¡ | â–¡ | â–¡ | â–¡ |
Reach and get down a five pound object | â–¡ | â–¡ | â–¡ | â–¡ |
Bend down & pick up clothing from floor | â–¡ | â–¡ | â–¡ | â–¡ |
Open car doors | â–¡ | â–¡ | â–¡ | â–¡ |
Open jars which have been opened | â–¡ | â–¡ | â–¡ | â–¡ |
Turn faucets on and off | â–¡ | â–¡ | â–¡ | â–¡ |
Run errands and shop | â–¡ | â–¡ | â–¡ | â–¡ |
Get in and out of a car | â–¡ | â–¡ | â–¡ | â–¡ |
Do chores i.e. vacuuming or yard work | â–¡ | â–¡ | â–¡ | â–¡ |