| 86 | PFC39 | Are you able to stand without losing your balance for several minutes? |
| 87 | PFC40 | Are you able to kneel on the floor? |
| 88 | PFC41 | Are you able to sit down in and stand up from a low, soft couch? |
| 89 | PFC43 | Are you able to use your hands, such as for turning faucets, using kitchen gadgets, or sewing? |
| 90 | PFC45 | Are you able to get on and off the toilet? |
| 91 | PFC46 | Are you able to transfer from a bed to a chair and back? |
| 92 | PFC47 | Are you able to be out of bed most of the day? |
| 93 | PFC49 | Are you able to water a house plant? |
| 94 | PFC51 | Are you able to wipe yourself after using the toilet? |
| 95 | PFC52 | Are you able to turn from side to side in bed? |
| 96 | PFC53 | Are you able to get in and out of bed? |
| 97 | PFC6 | Are you able to walk a block on flat ground? |
| 98 | PFC7 | Are you able to run five miles? |
| 99** | PFA1 | Does your health now limit you in doing vigorous activities, such as running, lifting heavy objects, participating in strenuous sports? |
| 100 | PFA3 | Does your health now limit you in bending, kneeling, or stooping? |
| 101 | PFA4 | Does your health now limit you in doing heavy work around the house like scrubbing floors, or lifting or moving heavy furniture? |
| 102 | PFA5 | Does your health now limit you in lifting or carrying groceries? |
| 103 | PFA6 | Does your health now limit you in bathing or dressing yourself? |
| 104 | PFA7 | How much do physical health problems now limit your usual physical activities (such as walking or climbing stairs)? |
| 105 | PFB1 | Does your health now limit you in doing moderate work around the house like vacuuming, sweeping floors or carrying in groceries? |
| 106 | PFB3 | Does your health now limit you in putting a trash bag outside? |
| 107 | PFB43 | Does your health now limit you in taking care of your personal needs (dress, comb hair, toilet, eat, bathe)? |
| 108 | PFB44 | Does your health now limit you in doing moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf? |
| 109 | PFB48 | Does your health now limit you in taking a shower? |
| 110 | PFB49 | Does your health now limit you in going for a short walk (less than 15 minutes)? |
| 111 | PFB5 | Does your health now limit you in hiking a couple of miles on uneven surfaces, including hills? |
| 112 | PFB51 | Does your health now limit you in participating in active sports such as swimming, tennis, or basketball? |
| 113 | PFB54 | Does your health now limit you in going OUTSIDE the home, for example to shop or visit a doctor’s office? |
| 114 | PFB7 | Does your health now limit you in doing strenuous activities such as backpacking, skiing, playing tennis, bicycling or jogging? |
| 115 | PFC10 | Does your health now limit you in climbing several flights of stairs? |
| 116 | PFC12 | Does your health now limit you in doing two hours of physical labor? |
| 117 | PFC20 | Does your health now limit you in walking one hundred yards? |
| 118 | PFC34 | Does your health now limit you in walking several hundred yards? |
| 119 | PFC35 | Does your health now limit you in doing eight hours of physical labor? |
| 120 | PFC36 | Does your health now limit you in walking more than a mile? |
| 121 | PFC37 | Does your health now limit you in climbing one flight of stairs? |
| 122 | PFC54 | Does your health now limit you in getting in and out of the bathtub? |
| 123 | PFC56 | Does your health now limit you in walking about the house? |
| 124*** | PFB50 | How much difficulty do you have doing your daily physical activities, because of your health? |