Item Number | ID* | Items** |
1 | PFA1 | Does your health now limit you in doing vigorous activities, such as running, lifting heavy objects, participating in strenuous sports? |
2 | PFA3 | Does your health now limit you in bending, kneeling, or stooping? |
3 | PFA4 | Does your health now limit you in doing heavy work around the house like scrubbing floors, or lifting or moving heavy furniture? |
4 | PFA5 | Does your health now limit you in lifting or carrying groceries? |
5 | PFA6 | Does your health now limit you in bathing or dressing yourself? |
6 | PFA7 | How much do physical health problems now limit your usual physical activities (such as walking or climbing stairs)? |
7 | PFA8 | Are you able to move a chair from one room to another? |
8 | PFA9 | Are you able to bend down and pick up clothing from the floor? |
9 | PFA10 | Are you able to stand for one hour? |
10 | PFA11 | Are you able to do chores such as vacuuming or yard work? |
11 | PFA12 | Are you able to push open a heavy door? |
12 | PFA13 | Are you able to exercise for an hour? |
13 | PFA14 | Are you able to carry a heavy object (over 10 pounds)? |
14 | PFA15 | Are you able to stand up from an armless straight chair? |
15 | PFA19 | Are you able to run or jog for two miles? |
16 | PFA21 | Are you able to go up and down stairs at a normal pace? |
17 | PFA23 | Are you able to go for a walk of at least 15 minutes? |
18 | PFA25 | Are you able to do yard work like raking leaves, weeding, or pushing a lawn mower? |
19 | PFA29 | Are you able to pull heavy objects (10 pounds) towards yourself? |
20 | PFA30 | Are you able to step up and down curbs? |
21 | PFA31 | Are you able to get up off the floor from lying on your back without help? |
22 | PFA32 | Are you able to stand with your knees straight? |
23 | PFA33 | Are you able to exercise hard for half an hour? |
24 | PFA37 | Are you able to stand for short periods of time? |
25 | PFA39 | Are you able to run at a fast pace for two miles? |
26 | PFA41 | Are you able to squat and get up? |
27 | PFA42 | Are you able to carry a laundry basket up a flight of stairs? |
28 | PFA45 | Are you able to get out of bed into a chair? |
29 | PFA49 | Are you able to bend or twist your back? |
30 | PFA51 | Are you able to sit on the edge of a bed? |
31 | PFA53 | Are you able to run errands and shop? |
32 | PFA56 | Are you able to get in and out of a car? |
33 | PFB1 | Does your health now limit you in doing moderate work around the house like vacuuming, sweeping floors or carrying in groceries? |
34 | PFB3 | Does your health now limit you in putting a trash bag outside? |
35 | PFB5 | Does your health now limit you in hiking a couple of miles on uneven surfaces, including hills? |
36 | PFB7 | Does your health now limit you in doing strenuous activities such as backpacking, skiing, playing tennis, bicycling or jogging? |
37 | PFB8 | Are you able to carry two bags filled with groceries 100 yards? |
38 | PFB9 | Are you able to jump up and down? |
39 | PFB10 | Are you able to climb up five steps? |
40 | PFB11 | Are you able to wash dishes, pots, and utensils by hand while standing at a sink? |