Table 5 PROMIS v1.2 Physical Function item bank

1

PFA10

Are you able to stand for one hour?^a

2

PFA11

Are you able to do chores such as vacuuming or yard work?

3

PFA12

Are you able to push open a heavy door?

4

PFA13

Are you able to exercise for an hour?

5

PFA14r1

Are you able to carry a heavy object (over 10 pounds/ 5 kg)?

6

PFA15

Are you able to stand up from an armless straight chair?

7

PFA16r1

Are you able to dress yourself, including tying shoelaces and buttoning up your clothes?

8

PFA17

Are you able to reach into a high cupboard?

9

PFA18

Are you able to use a hammer to pound a nail?

10

PFA19r1

Are you able to run or jog for two miles (3 km)?

11

PFA20

Are you able to cut your food using eating utensils?

12

PFA21

Are you able to go up and down stairs at a normal pace?

13

PFA22

Are you able to open previously opened jars?

14

PFA23

Are you able to go for a walk of at least 15 min?

15

PFA25

Are you able to do yard work like raking leaves, weeding, or pushing a lawn mower?

16

PFA28

Are you able to open a can with a hand can opener?

17

PFA29r1

Are you able to pull heavy objects (10 pounds/5 kg) towards yourself?

18

PFA30

Are you able to step up and down curbs?

19

PFA31r1

Are you able to get up from the floor from lying on your back without help?

20

PFA32

Are you able to stand with your knees straight?

21

PFA33

Are you able to exercise hard for half an hour?

22

PFA34

Are you able to wash your back?

23

PFA35

Are you able to open and close a zipper?

24

PFA36

Are you able to put on and take off a coat or jacket?

25

PFA37

Are you able to stand for short periods of time?

26

PFA38

Are you able to dry your back with a towel?

27

PFA39r1

Are you able to run at a fast pace for two miles (3 km)?

28

PFA40

Are you able to turn a key in a lock?

29

PFA41

Are you able to squat and get up?

30

PFA42

Are you able to carry a laundry basket up a flight of stairs?

31

PFA43

Are you able to write with a pen or pencil?

32

PFA44

Are you able to put on a shirt or blouse?

33

PFA45

Are you able to get out of bed into a chair?

34

PFA47

Are you able to pull on trousers?

35

PFA48

Are you able to peel fruit?

36

PFA49

Are you able to bend or twist your back?

37

PFA50

Are you able to brush your teeth?

38

PFA51

Are you able to sit on the edge of a bed?

39

PFA52

Are you able to tie your shoelaces?

40

PFA53

Are you able to run errands and shop?

41

PFA54

Are you able to button your shirt?

42

PFA55

Are you able to wash and dry your body?

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

PFB28r1

Are you able to lift 10 pounds (5 kg) 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 min?

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

PFB39r1

Are you able to reach and get down a 5 pound (2 kg) 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 min?

77

PFB56r1

Are you able to lift one pound (0.5 kg) to shoulder level without bending your elbow?

78

PFB8r1

Are you able to carry two bags filled with groceries 100 yards (100 m)?

79

PFB9

Are you able to jump up and down?

80

PFC13r1

Are you able to run 100 yards (100 m)?

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

PFC33r1

Are you able to run ten miles (16 km)?

85

PFC38

Are you able to walk at a normal speed?

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

PFC45r1

Are you able to sit on and get up from 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

PFC6r1

Are you able to walk a block (100 m) on flat ground?

98

PFC7r1

Are you able to run five miles (8 km)?

99

PFA1

Does your health now limit you in doing vigorous activities, such as running, lifting heavy objects, participating in strenuous sports?^b

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?

PFB1

Does your health now limit you in doing moderate work around the house like vacuuming, sweeping floors or carrying in groceries?

105

PFB3

Does your health now limit you in putting a trash bag outside?

106

PFB43

Does your health now limit you in taking care of your personal needs (dress, comb hair, toilet, eat, bathe)?

107

PFB44

Does your health now limit you in doing moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf?

108

PFB48

Does your health now limit you in taking a shower?

109

PFB49

Does your health now limit you in going for a short walk (less than 15 min)?

110

PFB5r1

Does your health now limit you in hiking a couple of miles (3 km) on uneven surfaces, including hills?

111

PFB51

Does your health now limit you in participating in active sports such as swimming, tennis, or basketball?

112

PFB54

Does your health now limit you in going OUTSIDE the home, for example to shop or visit a doctor’s office?

113

PFB7

Does your health now limit you in doing strenuous activities such as backpacking, skiing, playing tennis, bicycling or jogging?

114

PFC10

Does your health now limit you in climbing several flights of stairs?

115

PFC12

Does your health now limit you in doing two hours of physical labor?

116

PFC35

Does your health now limit you in doing eight hours of physical labor?

PFC36r1

Does your health now limit you in walking more than a mile (1.6 km)?

PFC37

Does your health now limit you in climbing one flight of stairs?

119

PFC54

Does your health now limit you in getting in and out of the bathtub?

120

PFC56

Does your health now limit you in walking about the house?

121

PFB50

How much difficulty do you have doing your daily physical activities, because of your health?^c