Version 2.78

78081-7 Are you able to carry a heavy object (over 10 pounds /5 kg)?

Fully-Specified Name

Component
Are you able to carry a heavy object (over 10 pounds or 5 kg)
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.54
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
Are you able to carry a heavy object (over 10 pounds /5 kg)?
Source
PFA14r1

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
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0
92605-5 PROMIS short form - upper extremity 7a - version 2.0

78048-6 Are you able to dress yourself, including tying shoelaces and buttoning your clothes?

Fully-Specified Name

Component
Are you able to dress yourself, including tying shoelaces and buttoning your clothes
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.54
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
Are you able to dress yourself, including tying shoelaces and buttoning your clothes?
Source
PFA16r1

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
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0
92580-0 PROMIS short form - physical function 10a - version 2.0

61603-7 Are you able to reach into a high cupboard?

Fully-Specified Name

Component
Are you able to reach into a high cupboard
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 reach into a high cupboard?
Source
Mobility-FA17

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
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0

61604-5 Are you able to use a hammer to pound a nail?

Fully-Specified Name

Component
Are you able to use a hammer to pound a nail
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 use a hammer to pound a nail?
Source
Mobility-FA18

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
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
79062-6 PROMIS item bank - physical function w mobility aids - version 1.0
91611-4 PROMIS item bank - upper extremity - version 2.0

61606-0 Are you able to cut your food using eating utensils?

Fully-Specified Name

Component
Are you able to cut your food using eating utensils
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 cut your food using eating utensils?
Source
Mobility-FA20

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
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
91611-4 PROMIS item bank - upper extremity - version 2.0

61611-0 Are you able to open a can with a hand can opener?

Fully-Specified Name

Component
Are you able to open a can with a hand can opener
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 open a can with a hand can opener?
Source
Mobility-FA28

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
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
91611-4 PROMIS item bank - upper extremity - version 2.0

78082-5 Are you able to pull heavy objects (10 pounds/ 5 kg) towards yourself?

Fully-Specified Name

Component
Are you able to pull heavy objects (10 pounds or 5 kg) towards yourself
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.54
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
Are you able to pull heavy objects (10 pounds/ 5 kg) towards yourself?
Source
PFA29r1

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
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0

61617-7 Are you able to wash your back?

Fully-Specified Name

Component
Are you able to wash your back
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 wash your back?
Source
Mobility-FA34

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
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
91611-4 PROMIS item bank - upper extremity - version 2.0
76702-0 PROMIS short form - physical function 20a - version 1.0
92605-5 PROMIS short form - upper extremity 7a - version 2.0

61618-5 Are you able to open and close a zipper?

Fully-Specified Name

Component
Are you able to open and close a zipper
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 open and close a zipper?
Source
Mobility-FA35

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
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
67906-8 Neuro-Qol short form - upper 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
91611-4 PROMIS item bank - upper extremity - version 2.0

61619-3 Are you able to put on and take off a coat or jacket?

Fully-Specified Name

Component
Are you able to put on and take off a coat or jacket
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 put on and take off a coat or jacket?
Source
Mobility-FA36

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
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0
92605-5 PROMIS short form - upper extremity 7a - version 2.0

61621-9 Are you able to dry your back with a towel?

Fully-Specified Name

Component
Are you able to dry your back with a towel
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 dry your back with a towel?
Source
Mobility-FA38

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
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0
76702-0 PROMIS short form - physical function 20a - version 1.0

61623-5 Are you able to turn a key in a lock?

Fully-Specified Name

Component
Are you able to turn a key in a lock
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 turn a key in a lock?
Source
Mobility-FA40

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
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
67906-8 Neuro-Qol short form - upper 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
91611-4 PROMIS item bank - upper extremity - version 2.0

61626-8 Are you able to write with a pen or pencil?

Fully-Specified Name

Component
Are you able to write with a pen or pencil
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 write with a pen or pencil?
Source
Mobility-FA43

Normative Answer List LL5290-3

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

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
67906-8 Neuro-Qol short form - upper 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
91611-4 PROMIS item bank - upper extremity - version 2.0

61627-6 Are you able to put on a shirt or blouse?

Fully-Specified Name

Component
Are you able to put on a shirt or blouse
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 put on a shirt or blouse?
Source
Mobility-FA44

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
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0

61630-0 Are you able to peel fruit?

Fully-Specified Name

Component
Are you able to peel fruit
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 peel fruit?
Source
Mobility-FA48

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
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
91611-4 PROMIS item bank - upper extremity - version 2.0

61632-6 Are you able to brush your teeth?

Fully-Specified Name

Component
Are you able to brush your teeth
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 brush your teeth?
Source
Mobility-FA50

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
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
67906-8 Neuro-Qol short form - upper extremity - version 1.0
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0

61636-7 Are you able to button your shirt?

Fully-Specified Name

Component
Are you able to button your shirt
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 button your shirt?
Source
Mobility-FA54

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
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0

61646-6 Are you able to wash dishes, pots, and utensils by hand while standing at a sink?

Fully-Specified Name

Component
Are you able to wash dishes, pots, and utensils by hand while standing at a sink
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 wash dishes, pots, and utensils by hand while standing at a sink?
Source
PFB11

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
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
79062-6 PROMIS item bank - physical function w mobility aids - version 1.0
91611-4 PROMIS item bank - upper extremity - version 2.0

61648-2 Are you able to carry a shopping bag or briefcase?

Fully-Specified Name

Component
Are you able to carry a shopping bag or briefcase
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 carry a shopping bag or briefcase?
Source
PFB13

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
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
79062-6 PROMIS item bank - physical function w mobility aids - version 1.0
91611-4 PROMIS item bank - upper extremity - version 2.0
92605-5 PROMIS short form - upper extremity 7a - version 2.0

61650-8 Are you able to change the bulb in a table lamp?

Fully-Specified Name

Component
Are you able to change the bulb in a table lamp
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 change the bulb in a table lamp?
Source
PFB15

Normative Answer List LL5291-1

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

Member of these Panels

LOINC Long Common Name
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
91611-4 PROMIS item bank - upper extremity - version 2.0

61651-6 Are you able to press with your index finger (for example ringing a doorbell)?

Fully-Specified Name

Component
Are you able to press with your index finger (for example ringing a doorbell)
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 press with your index finger (for example ringing a doorbell)?
Source
PFB16

Normative Answer List LL5290-3

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

Member of these Panels

LOINC Long Common Name
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
91611-4 PROMIS item bank - upper extremity - version 2.0

61653-2 Are you able to shave your face or apply makeup?

Fully-Specified Name

Component
Are you able to shave your face or apply makeup
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 shave your face or apply makeup?
Source
PFB18

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
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0

61654-0 Are you able to squeeze a new tube of toothpaste?

Fully-Specified Name

Component
Are you able to squeeze a new tube of toothpaste
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 squeeze a new tube of toothpaste?
Source
PFB19

Normative Answer List LL5290-3

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

Member of these Panels

LOINC Long Common Name
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
91611-4 PROMIS item bank - upper extremity - version 2.0
76702-0 PROMIS short form - physical function 20a - version 1.0

61655-7 Are you able to cut a piece of paper with scissors?

Fully-Specified Name

Component
Are you able to cut a piece of paper with scissors
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 cut a piece of paper with scissors?
Source
PFB20

Normative Answer List LL5290-3

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

Member of these Panels

LOINC Long Common Name
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
91611-4 PROMIS item bank - upper extremity - version 2.0

61656-5 Are you able to pick up coins from a table top?

Fully-Specified Name

Component
Are you able to pick up coins from a table top
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 pick up coins from a table top?
Source
PFB21

Normative Answer List LL5290-3

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

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
67906-8 Neuro-Qol short form - upper 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
91611-4 PROMIS item bank - upper extremity - version 2.0

61657-3 Are you able to hold a plate full of food?

Fully-Specified Name

Component
Are you able to hold a plate full of food
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 hold a plate full of food?
Source
PFB22

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
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0
76702-0 PROMIS short form - physical function 20a - version 1.0

61658-1 Are you able to pour liquid from a bottle into a glass?

Fully-Specified Name

Component
Are you able to pour liquid from a bottle into a glass
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 pour liquid from a bottle into a glass?
Source
PFB23

Normative Answer List LL5290-3

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

Member of these Panels

LOINC Long Common Name
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
91611-4 PROMIS item bank - upper extremity - version 2.0

61660-7 Are you able to push open a door after turning the knob?

Fully-Specified Name

Component
Are you able to push open a door after turning the knob
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 door after turning the knob?
Source
PFB25

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
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0

61661-5 Are you able to shampoo your hair?

Fully-Specified Name

Component
Are you able to shampoo your hair
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 shampoo your hair?
Source
PFB26

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
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
67906-8 Neuro-Qol short form - upper extremity - version 1.0
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0
62199-5 PROMIS short form - physical function 10a - version 1.0
92580-0 PROMIS short form - physical function 10a - version 2.0
76702-0 PROMIS short form - physical function 20a - version 1.0

61662-3 Are you able to tie a knot or a bow?

Fully-Specified Name

Component
Are you able to tie a knot or a bow
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 tie a knot or a bow?
Source
PFB27

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
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
91611-4 PROMIS item bank - upper extremity - version 2.0

78054-4 Are you able to lift 10 pounds (5 kg) above your shoulder?

Fully-Specified Name

Component
Are you able to lift 10 pounds (5 kg) above your shoulder
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.54
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
Are you able to lift 10 pounds (5 kg) above your shoulder?
Source
PFB28r1

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
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0
92579-2 PROMIS short form - physical function 10b - version 2.0
92605-5 PROMIS short form - upper extremity 7a - version 2.0

61665-6 Are you able to open a new milk carton?

Fully-Specified Name

Component
Are you able to open a new milk carton
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 open a new milk carton?
Source
PFB30

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
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
91611-4 PROMIS item bank - upper extremity - version 2.0

61666-4 Are you able to open car doors?

Fully-Specified Name

Component
Are you able to open car doors
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 open car doors?
Source
PFB31

Normative Answer List LL5290-3

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

Member of these Panels

LOINC Long Common Name
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
91611-4 PROMIS item bank - upper extremity - version 2.0

61668-0 Are you able to remove something from your back pocket?

Fully-Specified Name

Component
Are you able to remove something from your back pocket
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 remove something from your back pocket?
Source
PFB33

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
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0

61669-8 Are you able to change a light bulb overhead?

Fully-Specified Name

Component
Are you able to change a light bulb overhead
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 change a light bulb overhead?
Source
PFB34

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
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
91611-4 PROMIS item bank - upper extremity - version 2.0
92605-5 PROMIS short form - upper extremity 7a - version 2.0

61670-6 Are you able to put on a pullover sweater?

Fully-Specified Name

Component
Are you able to put on a pullover sweater
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 put on a pullover sweater?
Source
PFB36

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
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0

61671-4 Are you able to turn faucets on and off?

Fully-Specified Name

Component
Are you able to turn faucets on and off
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 turn faucets on and off?
Source
PFB37

Normative Answer List LL5290-3

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

Member of these Panels

LOINC Long Common Name
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
91611-4 PROMIS item bank - upper extremity - version 2.0

78055-1 Are you able to reach and get down a 5 pound (2 kg) object from above your head?

Fully-Specified Name

Component
Are you able to reach and get down a 5 pound (2 kg) object from above your head
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.54
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
Are you able to reach and get down a 5 pound (2 kg) object from above your head?
Source
PFB39r1

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
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0

61674-8 Are you able to trim your fingernails?

Fully-Specified Name

Component
Are you able to trim your fingernails
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 trim your fingernails?
Source
PFB41

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
67892-0 Neuro-Qol item bank - upper 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
91611-4 PROMIS item bank - upper extremity - version 2.0

78056-9 Are you able to lift one pound (0.5 kg) to shoulder level without bending your elbow?

Fully-Specified Name

Component
Are you able to lift one pound (0.5 kg) to shoulder level without bending your elbow
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.54
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
Are you able to lift one pound (0.5 kg) to shoulder level without bending your elbow?
Source
PFB56r1

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
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0

61703-5 Are you able to use your hands, such as for turning faucets, using kitchen gadgets, or sewing?

Fully-Specified Name

Component
Are you able to use your hands, such as for turning faucets, using kitchen gadgets, or sewing
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 use your hands, such as for turning faucets, using kitchen gadgets, or sewing?
Source
PFC43

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
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
91611-4 PROMIS item bank - upper extremity - version 2.0

61707-6 Are you able to water a house plant?

Fully-Specified Name

Component
Are you able to water a house plant
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 water a house plant?
Source
PFC49

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
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
91611-4 PROMIS item bank - upper extremity - version 2.0

91610-6 Are you able to lift a heavy painting or picture to hang on your wall above eye-level?

Fully-Specified Name

Component
Are you able to lift a heavy painting or picture to hang on your wall above eye-level
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.66
Last Updated
Version 2.66
Order vs. Observation
Observation

Survey Question

Text
Are you able to lift a heavy painting or picture to hang on your wall above eye-level?
Source
PFM2

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
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0

91608-0 Are you able to pass a 20-pound (10 kg) turkey or ham to other people at the table?

Fully-Specified Name

Component
Are you able to pass a 20-pound (10 kg) turkey or ham to other people at the table
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.66
Last Updated
Version 2.66
Order vs. Observation
Observation

Survey Question

Text
Are you able to pass a 20-pound (10 kg) turkey or ham to other people at the table?
Source
PFM16

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
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0
92605-5 PROMIS short form - upper extremity 7a - version 2.0

91609-8 Are you able to continuously swing a baseball bat or tennis racket back and forth for 5 minutes?

Fully-Specified Name

Component
Are you able to continuously swing a baseball bat or tennis racket back and forth for 5M
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.66
Last Updated
Version 2.66
Order vs. Observation
Observation

Survey Question

Text
Are you able to continuously swing a baseball bat or tennis racket back and forth for 5 minutes?
Source
PFM18

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
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0

91607-2 Does your health now limit you in opening a previously opened jar?

Fully-Specified Name

Component
Does your health now limit you in opening a previously opened jar
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.66
Last Updated
Version 2.66
Order vs. Observation
Observation

Survey Question

Text
Does your health now limit you in opening a previously opened jar?
Source
PFC8

Normative Answer List LL1021-6

Answer Code Score Answer ID
Not at all 5 LA6568-5
Very little 4 LA13947-9
Somewhat 3 LA13909-9
Quite a lot 2 LA11911-7
Cannot do 1 LA13868-7

Member of these Panels

LOINC Long Common Name
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0

91612-2 PROMIS upper extremity version 2.0 T-score

Fully-Specified Name

Component
PROMIS upper extremity version 2.0 T-score
Property
Tscore
Time
Pt
System
^Patient
Scale
Qn
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.66
Last Updated
Version 2.66
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
76464-7 American Physical Therapy Association registry panel
91611-4 PROMIS item bank - upper extremity - version 2.0
92605-5 PROMIS short form - upper extremity 7a - version 2.0

Example Units

Unit Source
{Tscore} Example UCUM Units