File name: Knee outcome survey pdf
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(check one answer on Instructions: The following questionnaire is designed to determine the symptoms and limitations that you experience because of your knee while you perform your usual daily The Knee Outcome Survey is a patient self report survey that includes an Activities of Daily Living Scale (ADLS) and a Sports Activity Scale (SAS). Swelling. Limping. Limping. (check one answer on each line) I do not have the symptom I have the symptom, but it does not affect my activity The symptom affects my activity slightly The symptom affects my activity moderately INSTRUCTIONS FOR THE: KNEE OUTCOME SURVEY, ACTIVITY OF DAILY LIVING SCALE (ADLS) This questionnaire has been designed to give your therapist information as to how your knee condition has affected your ability to manage in every day life. The following questionnaire is designed to determine the symptoms and limitations that you experience because of Knee injury and Osteoarthritis Outcome Score (KOOS), English version LKFor each of the following activities please indicate the degree of difficulty you have experienced in KNEE OUTCOME SURVEY Activities of Daily Living Scale Symptoms: To what degree does each of the following symptoms affect your level of activity? Stiffness. The ADLS is aitem scale that queries patients about how their knee symptoms effect their ability to perform general daily activities (6 items) as well as how their knee condition effects their Pain. Stiffness. Please answer each pain or symptom descriptor Giving way, buckling, or shifting of the knee Weakness. Swelling. Pain. Functional Limitations With Activities of Daily Living: How does your knee affect your Click here to download a PDF of your completed report. Giving way, buckling, or shifting of the knee Weakness. Functional Limitations With Activities of Daily Living: How does your knee affect your ability to: (check one answer on each line) Knee injury and Osteoarthritis Outcome Score (KOOS), English version LKFor each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee KNEE OUTCOME SURVEY Activities of Daily Living Scale Symptoms: To what degree does each of the following symptoms affect your level of activity?
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