| 43 | PFA56 | Are you able to get in and out of a car? |
| 44 | PFA8 | Are you able to move a chair from one room to another? |
| 45 | PFA9 | Are you able to bend down and pick up clothing from the floor? |
| 46 | PFB10 | Are you able to climb up five steps? |
| 47 | PFB11 | Are you able to wash dishes, pots, and utensils by hand while standing at a sink? |
| 48 | PFB12 | Are you able to make a bed, including spreading and tucking in bed sheets? |
| 49 | PFB13 | Are you able to carry a shopping bag or briefcase? |
| 50 | PFB14 | Are you able to take a tub bath? |
| 51 | PFB15 | Are you able to change the bulb in a table lamp? |
| 52 | PFB16 | Are you able to press with your index finger (for example ringing a doorbell)? |
| 53 | PFB17 | Are you able to put on and take off your socks? |
| 54 | PFB18 | Are you able to shave your face or apply makeup? |
| 55 | PFB19 | Are you able to squeeze a new tube of toothpaste? |
| 56 | PFB20 | Are you able to cut a piece of paper with scissors? |
| 57 | PFB21 | Are you able to pick up coins from a table top? |
| 58 | PFB22 | Are you able to hold a plate full of food? |
| 59 | PFB23 | Are you able to pour liquid from a bottle into a glass? |
| 60 | PFB24 | Are you able to run a short distance, such as to catch a bus? |
| 61 | PFB25 | Are you able to push open a door after turning the knob? |
| 62 | PFB26 | Are you able to shampoo your hair? |
| 63 | PFB27 | Are you able to tie a knot or a bow? |
| 64 | PFB28 | Are you able to lift 10 pounds above your shoulder? |
| 65 | PFB29 | Are you able to lift a full cup or glass to your mouth? |
| 66 | PFB30 | Are you able to open a new milk carton? |
| 67 | PFB31 | Are you able to open car doors? |
| 68 | PFB32 | Are you able to stand unsupported for 10 minutes? |
| 69 | PFB33 | Are you able to remove something from your back pocket? |
| 70 | PFB34 | Are you able to change a light bulb overhead? |
| 71 | PFB36 | Are you able to put on a pullover sweater? |
| 72 | PFB37 | Are you able to turn faucets on and off? |
| 73 | PFB39 | Are you able to reach and get down a 5 pound object from above your head? |
| 74 | PFB40 | Are you able to stand up on tiptoes? |
| 75 | PFB41 | Are you able to trim your fingernails? |
| 76 | PFB42 | Are you able to stand unsupported for 30 minutes? |
| 77 | PFB56 | Are you able to lift one pound (a full pint container) to shoulder level without bending your elbow? |
| 78 | PFB8 | Are you able to carry two bags filled with groceries 100 yards? |
| 79 | PFB9 | Are you able to jump up and down? |
| 80 | PFC13 | Are you able to run 100 yards? |
| 81 | PFC29 | Are you able to walk up and down two steps? |
| 82 | PFC31 | Are you able to reach into a low cupboard? |
| 83 | PFC32 | Are you able to climb up 5 flights of stairs? |
| 84 | PFC33 | Are you able to run ten miles? |
| 85 | PFC38 | Are you able to walk at a normal speed? |