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HAQ - Health Assessment Questionaire

  • HAQ is used for assessing the disability level in patients of Musculo-Skeletal diseases.
  • Reference: Modified from Stanford HAQ 20-Item Disability Scale
Institute of Rheumatology and Pain - www. arthritiscare.co.in
HAQ - HEALTH ASSESSMENTQUESTIONAIRE
Instructions: Please score 0-3 for your abilities over the past week
Note: Leave blank if you normaly do not do any activity.
Were you able to do the following: SCORE
A DRESSING  
1 Put on clothes with buttons and shoe with laces? Score 0 - Without ANY difficulty
2 Wash/ Shampoo/ Soap your hair?
B ARISING
3 Stand up from a staright chair?
4 Get in and out of bed?
C EATING  
5 Cut your vegetables/meat? Score 1 - NO Aids and devices and help from others. With SOME difficulty
6 Lift your Cup or glass to your mouth?
7 Open a new milk carton?
D WALKING
8 Walk outdoors on a flat surface?
9 Climb up 5 steps?
E HYGIENE  
10 Wash and dry your body? Score 2 - With Aids and devices and help from others. With MUCH difficulty
11 Take a Tub Bath?
12 Geton and off the toilet?
F REACH
13 Get down a 5 pound obeject from overhead?
14 Bend down and pick things from the floor?
G GRIP  
15 Open car doors? Score 3 - With Aids and devices and help from others. UNABLE to do at all
16 Open jars and containers?
17 Turn Tap on and off?
H ACTIVITIES
18 Run errands and shop?
19 Get in and out of Car?
20 Do chores like vaccuming or yard/garden work?  
Score