Questions and possible answers | Number of points |
---|---|
Pain—30 points |  |
Intense, continuous at test | 0–5 |
Intense with activity | 10 |
Tolerable but limits activity | 15 |
With moderate activity, abolished at rest | 20 |
Mild, intermittent, normal activity | 25 |
Slight, occasional, or no pain | 30 |
Work—20 points |  |
No regular job | 0–4 |
Light work | 8 |
Change of job | 12 |
Same job, reduced performance | 16 |
Same job, same performance | 20 |
Sitting—10 points |  |
Painful | 0–4 |
Painful if prolonged or awkward | 6 |
Uncomfortable | 8 |
Free | 10 |
Sexual intercourse—4 points |  |
Painful (or if man erection not possible) | 0–1 |
Painful if prolonged or awkward | 2 |
Uncomfortable, different from before | 3 |
No complaints | 4 |
Standing—36 points |  |
Walking aids (11) | Â |
 Bedridden or almost | 0–2 |
 Wheelchair | 4 |
 Two crutches | 6 |
 Two sticks | 8 |
 One stick | 10 |
 No sticks | 12 |
Gait unaided (11) | Â |
 Cannot walk or almost | 0–2 |
 Shuffling small steps | 4 |
 Gross limp | 6 |
 Moderate limp | 8 |
 Slight limp | 10 |
 Normal | 12 |
Walking distance (11) | Â |
 Bed ridden or few meters | 0–2 |
 Very limited time and distance | 4 |
 Limited with sticks, difficult without, prolonged standing possible | 6 |
 One hour with a stick, limited without | 8 |
 One hour without sticks, slight pain or limp | 10 |
 Normal for age and general condition | 12 |
Total | 100 |