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Lower extremity functional scale military form

Lower extremity functional scale military form 2026

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The document is a questionnaire titled 'The Lower Extremity Functional Scale' designed to assess difficulties individuals may experience in various activities due to lower limb problems. It includes a list of activities and a scoring system for respondents to indicate their level of difficulty, ranging from 'No Difficulty' to 'Extreme Difficulty or Unable to Perform Activity.' The purpose is to evaluate functional limitations and track changes over time.

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Click ‘Get Form’ to open the lower extremity functional scale military form in the editor.
Begin by entering your name and the date at the top of the form. This personal information is essential for tracking your progress.
Next, fill in the name of your primary therapist. This helps ensure that your responses are directed to the right professional.
Review each activity listed on the form. For each activity, indicate any difficulty you experience by selecting a score from 0 (No Difficulty) to 4 (Extreme Difficulty or Unable to Perform Activity).
Once you have completed all activities, sum up your scores in the 'Column Totals' section to calculate your overall score.
Finally, sign the document at the bottom to confirm that all information provided is accurate.

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