Version 2.78

61704-3 Are you able to get on and off the toilet?

Fully-Specified Name

Component
Are you able to get on and off the toilet
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to get on and off the toilet?
Source
PFC45

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67893-8 Neuro-Qol item bank - lower extremity - version 1.0
67907-6 Neuro-Qol short form - lower extremity - version 1.0
61587-2 PROMIS item bank - physical function - version 1.0
62199-5 PROMIS short form - physical function 10a - version 1.0
76702-0 PROMIS short form - physical function 20a - version 1.0

61613-6 Are you able to step up and down curbs?

Fully-Specified Name

Component
Are you able to step up and down curbs
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to step up and down curbs?
Source
Mobility-FA30

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67893-8 Neuro-Qol item bank - lower extremity - version 1.0
67907-6 Neuro-Qol short form - lower extremity - version 1.0
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
79062-6 PROMIS item bank - physical function w mobility aids - version 1.0

61638-3 Are you able to get in and out of a car?

Fully-Specified Name

Component
Are you able to get in and out of a car
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to get in and out of a car?
Source
Mobility-FA56

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67893-8 Neuro-Qol item bank - lower extremity - version 1.0
67907-6 Neuro-Qol short form - lower extremity - version 1.0
89689-4 PROMIS cancer item bank - physical function - version 1.1
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
92579-2 PROMIS short form - physical function 10b - version 2.0
76702-0 PROMIS short form - physical function 20a - version 1.0

61628-4 Are you able to get out of bed into a chair?

Fully-Specified Name

Component
Are you able to get out of bed into a chair
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to get out of bed into a chair?
Source
Mobility-FA45

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67893-8 Neuro-Qol item bank - lower extremity - version 1.0
67907-6 Neuro-Qol short form - lower extremity - version 1.0
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0

61598-9 Are you able to push open a heavy door?

Fully-Specified Name

Component
Are you able to push open a heavy door
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to push open a heavy door?
Source
Mobility-FA12

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67893-8 Neuro-Qol item bank - lower extremity - version 1.0
67907-6 Neuro-Qol short form - lower extremity - version 1.0
89689-4 PROMIS cancer item bank - physical function - version 1.1
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
76702-0 PROMIS short form - physical function 20a - version 1.0

61635-9 Are you able to run errands and shop?

Fully-Specified Name

Component
Are you able to run errands and shop
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to run errands and shop?
Source
Mobility-FA53

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
89070-7 ADAPTABLE patient reported item set [ADAPTABLE]
67893-8 Neuro-Qol item bank - lower extremity - version 1.0
67907-6 Neuro-Qol short form - lower extremity - version 1.0
75418-4 PCORI patient-reported outcomes common measures - core and recommended [PROMIS]
89689-4 PROMIS cancer item bank - physical function - version 1.1
62337-1 PROMIS item bank - 29 profile
62336-3 PROMIS item bank - 43 profile
62338-9 PROMIS item bank - 57 profile
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
92579-2 PROMIS short form - physical function 10b - version 2.0
76700-4 PROMIS short form - physical function 4a - version 1.0
76804-4 PROMIS short form - physical function 6b - version 1.2
76805-1 PROMIS short form - physical function 8b - version 1.2

61614-4 Are you able to get up off the floor from lying on your back without help?

Fully-Specified Name

Component
Are you able to get up off the floor from lying on your back without help
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to get up off the floor from lying on your back without help?
Source
Mobility-FA31

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67893-8 Neuro-Qol item bank - lower extremity - version 1.0
67907-6 Neuro-Qol short form - lower extremity - version 1.0
89689-4 PROMIS cancer item bank - physical function - version 1.1
91613-0 PROMIS item bank - mobility - version 2.0
61587-2 PROMIS item bank - physical function - version 1.0

61609-4 Are you able to go for a walk of at least 15 minutes?

Fully-Specified Name

Component
Are you able to go for a walk of at least 15 minutes
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to go for a walk of at least 15 minutes?
Source
Mobility-FA23

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67893-8 Neuro-Qol item bank - lower extremity - version 1.0
67907-6 Neuro-Qol short form - lower extremity - version 1.0
62337-1 PROMIS item bank - 29 profile
62336-3 PROMIS item bank - 43 profile
62338-9 PROMIS item bank - 57 profile
91613-0 PROMIS item bank - mobility - version 2.0
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
79062-6 PROMIS item bank - physical function w mobility aids - version 1.0
76700-4 PROMIS short form - physical function 4a - version 1.0
76804-4 PROMIS short form - physical function 6b - version 1.2
76805-1 PROMIS short form - physical function 8b - version 1.2

67942-3 How much DIFFICULTY do you currently have standing up from an armless straight chair (e.g., dining room chair)?

Fully-Specified Name

Component
How much difficulty do you currently have standing up from an armless straight chair, like a dining room chair
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
NeuroQol

Basic Attributes

Class
SURVEY.NEUROQ
Type
Surveys
First Released
Version 2.38
Last Updated
Version 2.50

Survey Question

Text
How much DIFFICULTY do you currently have standing up from an armless straight chair (e.g., dining room chair)?
Source
NQMOB01

Normative Answer List LL1879-7

Answer Code Score Answer ID
No difficulty 5 LA15227-4
A little difficulty 4 LA15725-7
Some difficulty 3 LA13950-3
A lot of difficulty 2 LA13951-1
Can't do 1 LA17824-6

Member of these Panels

LOINC Long Common Name
67893-8 Neuro-Qol item bank - lower extremity - version 1.0

67943-1 How much DIFFICULTY do you currently have sitting down on and standing up from a chair with arms?

Fully-Specified Name

Component
How much difficulty do you currently have sitting down on and standing up from a chair with arms
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
NeuroQol

Basic Attributes

Class
SURVEY.NEUROQ
Type
Surveys
First Released
Version 2.38
Last Updated
Version 2.50

Survey Question

Text
How much DIFFICULTY do you currently have sitting down on and standing up from a chair with arms?
Source
NQMOB03

Normative Answer List LL1879-7

Answer Code Score Answer ID
No difficulty 5 LA15227-4
A little difficulty 4 LA15725-7
Some difficulty 3 LA13950-3
A lot of difficulty 2 LA13951-1
Can't do 1 LA17824-6

Member of these Panels

LOINC Long Common Name
67893-8 Neuro-Qol item bank - lower extremity - version 1.0

67944-9 How much DIFFICULTY do you currently have moving from sitting at the side of the bed to lying down on your back?

Fully-Specified Name

Component
How much difficulty do you currently have moving from sitting at the side of the bed to lying down on your back
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
NeuroQol

Basic Attributes

Class
SURVEY.NEUROQ
Type
Surveys
First Released
Version 2.38
Last Updated
Version 2.50

Survey Question

Text
How much DIFFICULTY do you currently have moving from sitting at the side of the bed to lying down on your back?
Source
NQMOB04

Normative Answer List LL1879-7

Answer Code Score Answer ID
No difficulty 5 LA15227-4
A little difficulty 4 LA15725-7
Some difficulty 3 LA13950-3
A lot of difficulty 2 LA13951-1
Can't do 1 LA17824-6

Member of these Panels

LOINC Long Common Name
67893-8 Neuro-Qol item bank - lower extremity - version 1.0

67945-6 How much DIFFICULTY do you currently have standing up from a low, soft couch?

Fully-Specified Name

Component
How much difficulty do you currently have standing up from a low, soft couch
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
NeuroQol

Basic Attributes

Class
SURVEY.NEUROQ
Type
Surveys
First Released
Version 2.38
Last Updated
Version 2.50

Survey Question

Text
How much DIFFICULTY do you currently have standing up from a low, soft couch?
Source
NQMOB06

Normative Answer List LL1879-7

Answer Code Score Answer ID
No difficulty 5 LA15227-4
A little difficulty 4 LA15725-7
Some difficulty 3 LA13950-3
A lot of difficulty 2 LA13951-1
Can't do 1 LA17824-6

Member of these Panels

LOINC Long Common Name
67893-8 Neuro-Qol item bank - lower extremity - version 1.0

67946-4 How much DIFFICULTY do you currently have going up and down a flight of stairs inside, using a handrail?

Fully-Specified Name

Component
How much difficulty do you currently have going up and down a flight of stairs inside, using a handrail
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
NeuroQol

Basic Attributes

Class
SURVEY.NEUROQ
Type
Surveys
First Released
Version 2.38
Last Updated
Version 2.50

Survey Question

Text
How much DIFFICULTY do you currently have going up and down a flight of stairs inside, using a handrail?
Source
NQMOB08

Normative Answer List LL1879-7

Answer Code Score Answer ID
No difficulty 5 LA15227-4
A little difficulty 4 LA15725-7
Some difficulty 3 LA13950-3
A lot of difficulty 2 LA13951-1
Can't do 1 LA17824-6

Member of these Panels

LOINC Long Common Name
67893-8 Neuro-Qol item bank - lower extremity - version 1.0

67947-2 How much DIFFICULTY do you currently have walking on uneven surfaces (e.g., grass, dirt road or sidewalk)?

Fully-Specified Name

Component
How much difficulty do you currently have walking on uneven surfaces, like grass, dirt road or sidewalk
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
NeuroQol

Basic Attributes

Class
SURVEY.NEUROQ
Type
Surveys
First Released
Version 2.38
Last Updated
Version 2.50

Survey Question

Text
How much DIFFICULTY do you currently have walking on uneven surfaces (e.g., grass, dirt road or sidewalk)?
Source
NQMOB09

Normative Answer List LL1879-7

Answer Code Score Answer ID
No difficulty 5 LA15227-4
A little difficulty 4 LA15725-7
Some difficulty 3 LA13950-3
A lot of difficulty 2 LA13951-1
Can't do 1 LA17824-6

Member of these Panels

LOINC Long Common Name
67893-8 Neuro-Qol item bank - lower extremity - version 1.0

67948-0 How much DIFFICULTY do you currently have walking around one floor of your home?

Fully-Specified Name

Component
How much difficulty do you currently have walking around one floor of your home
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
NeuroQol

Basic Attributes

Class
SURVEY.NEUROQ
Type
Surveys
First Released
Version 2.38
Last Updated
Version 2.50

Survey Question

Text
How much DIFFICULTY do you currently have walking around one floor of your home?
Source
NQMOB11

Normative Answer List LL1879-7

Answer Code Score Answer ID
No difficulty 5 LA15227-4
A little difficulty 4 LA15725-7
Some difficulty 3 LA13950-3
A lot of difficulty 2 LA13951-1
Can't do 1 LA17824-6

Member of these Panels

LOINC Long Common Name
67893-8 Neuro-Qol item bank - lower extremity - version 1.0

67949-8 How much DIFFICULTY do you currently have taking a 20-minute brisk walk, without stopping to rest?

Fully-Specified Name

Component
How much difficulty do you currently have taking a 20M brisk walk, without stopping to rest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
NeuroQol

Basic Attributes

Class
SURVEY.NEUROQ
Type
Surveys
First Released
Version 2.38
Last Updated
Version 2.50

Survey Question

Text
How much DIFFICULTY do you currently have taking a 20-minute brisk walk, without stopping to rest?
Source
NQMOB16

Normative Answer List LL1879-7

Answer Code Score Answer ID
No difficulty 5 LA15227-4
A little difficulty 4 LA15725-7
Some difficulty 3 LA13950-3
A lot of difficulty 2 LA13951-1
Can't do 1 LA17824-6

Member of these Panels

LOINC Long Common Name
67893-8 Neuro-Qol item bank - lower extremity - version 1.0

67950-6 How much DIFFICULTY do you currently have walking on a slippery surface, outdoors?

Fully-Specified Name

Component
How much difficulty do you currently have walking on a slippery surface, outdoors
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
NeuroQol

Basic Attributes

Class
SURVEY.NEUROQ
Type
Surveys
First Released
Version 2.38
Last Updated
Version 2.50

Survey Question

Text
How much DIFFICULTY do you currently have walking on a slippery surface, outdoors?
Source
NQMOB17

Normative Answer List LL1879-7

Answer Code Score Answer ID
No difficulty 5 LA15227-4
A little difficulty 4 LA15725-7
Some difficulty 3 LA13950-3
A lot of difficulty 2 LA13951-1
Can't do 1 LA17824-6

Member of these Panels

LOINC Long Common Name
67893-8 Neuro-Qol item bank - lower extremity - version 1.0

67951-4 How much DIFFICULTY do you currently have climbing stairs step over step without a handrail? (alternating feet)?

Fully-Specified Name

Component
How much difficulty do you currently have climbing stairs step over step without a handrail - alternating feet
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
NeuroQol

Basic Attributes

Class
SURVEY.NEUROQ
Type
Surveys
First Released
Version 2.38
Last Updated
Version 2.50

Survey Question

Text
How much DIFFICULTY do you currently have climbing stairs step over step without a handrail? (alternating feet)?
Source
NQMOB21

Normative Answer List LL1879-7

Answer Code Score Answer ID
No difficulty 5 LA15227-4
A little difficulty 4 LA15725-7
Some difficulty 3 LA13950-3
A lot of difficulty 2 LA13951-1
Can't do 1 LA17824-6

Member of these Panels

LOINC Long Common Name
67893-8 Neuro-Qol item bank - lower extremity - version 1.0

67952-2 How much DIFFICULTY do you currently have walking in a dark room without falling?

Fully-Specified Name

Component
How much difficulty do you currently have walking in a dark room without falling
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
NeuroQol

Basic Attributes

Class
SURVEY.NEUROQ
Type
Surveys
First Released
Version 2.38
Last Updated
Version 2.50

Survey Question

Text
How much DIFFICULTY do you currently have walking in a dark room without falling?
Source
NQMOB23

Normative Answer List LL1879-7

Answer Code Score Answer ID
No difficulty 5 LA15227-4
A little difficulty 4 LA15725-7
Some difficulty 3 LA13950-3
A lot of difficulty 2 LA13951-1
Can't do 1 LA17824-6

Member of these Panels

LOINC Long Common Name
67893-8 Neuro-Qol item bank - lower extremity - version 1.0