Skip to main content

Advertisement

Table 5 PROMIS v1.2 Physical Function item bank

From: The responsiveness of the PROMIS instruments and the qDASH in an upper extremity population

Item ID Questions
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?
104 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?
117 PFC36r1 Does your health now limit you in walking more than a mile (1.6 km)?
118 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
  1. aResponse options for questions 1–98 are 1 = Unable to do; 2 = With much difficulty; 3 = With some difficulty; 4 = With a little difficulty; 5 = Without any difficulty
  2. bResponse options for questions 99–123 are 1 = Cannot do; 2 = Quite a lot; 3 = Somewhat; 4 = Very little; 5 = Not at all
  3. cResponse options for question 121 are 1 = Can’t do because of health, 2 = A lot of difficulty; 3 = Some difficulty; 4 = A little bit of difficulty; 5 = No difficulty at all