Lower extremity functional form 2025

See details

4.5 out of 5

34 votes

The document is a Lower Extremity Functional Scale (LEFS) questionnaire designed to assess a patient's difficulty with various activities due to lower limb problems. It includes a list of activities and asks patients to rate their level of difficulty, providing a total score that reflects their functional status.

Here's how it works

01. Edit your lefs calculator online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send lower extremity functional scale calculator via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out lower extremity functional form with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the lower extremity functional form in the editor.
Begin by entering your name in the designated field at the top of the form. This personalizes your submission and ensures accurate tracking.
Review each activity listed in the form carefully. For each activity, select one of the difficulty levels: 'No Difficulty', 'A Little Bit of Difficulty', 'Moderate Difficulty', 'Quite a Bit of Difficulty', or 'Extreme Difficulty or Unable to Perform Activity'.
Continue through all 20 activities, providing your response for each. This will help assess your lower limb functionality effectively.
Once you have completed all sections, check the total score section at the bottom. Ensure that your scores are accurately totaled for a comprehensive overview.

Start using our platform today to fill out your lower extremity functional form online for free!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do you assess lower extremities?

The patient is positioned in side lying with the test knee is full extension and the test hip in slight extension. The HHD is placed just proximal to the lateral malleolus. The patient is instructed to apply a maximal isometric effort force against the HHD and the average of 3 trials is recorded for each limb.

What is a good lower extremity functional scale score?

However, scores in the range of 61-80 are generally considered normal or indicative of minimal functional limitation. Scores in the range of 41-60 may indicate mild to moderate functional limitation, while scores in the range of 20-40 may indicate moderate to severe functional limitation.

How do you document a lower extremity assessment?

Documentation of a basic, normal extremity exam should look something along the lines of the following: Extremities are atraumatic in appearance without tenderness or deformity. Extremities are without swelling or erythema. Full range of motion is noted to all joints.

How do you document a patient assessment?

Document the patients vital signs: Blood pressure. Pulse rate. Respiratory rate. SpO2 (also document supplemental oxygen if relevant) Temperature (including any recent fevers)

What is the lower extremity functional scale TAC?

Lower Extremity Functional Scale (LEFS) Can be used to monitor changes in functioning during treatment interventions. A change in score of 9 points or more is likely to represent a clinically meaningful change (MCID).

lefs score calculator

Lower Extremity Functional Scale PDF Lower Extremity Functional Index Lower Extremity Functional Scale interpretation Lower Extremity Functional test PDF Lower Extremity Functional Scale calculator Lower Extremity Functional Scale scoring Lower Extremity Functional Scale printable Lower Extremity Functional scale online

What is the lower leg functional test?

The Lower Extremity Functional Test (LEFT), is a reliable and valid test for the measurement of athletic fitness, fatigue resistance, and speed by performing a series of 16 specific maneuvers as fast as possible (including forward and backward sprinting, sidestepping, cross-stepping, 45 and 90 change of direction).

How should the nurse assess for lower extremity?

1:56 4:27 Out. Very good so very strong full strength against resistance of the hip. And we had had full rangeMoreOut. Very good so very strong full strength against resistance of the hip. And we had had full range of motion. So the hip would get five out of five.