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Osteoarthritis Self assessment

Institute of Rheumatology and Pain - www. arthritiscare.co.in
Osteoarthritis Self assessment scoring
To be used to monitor the course of the disease or to determine the effectiveness of treatment in Osteoarthritis of the Hip and Knee.
Please use the sliding scale to the appropriate position.
Pain Score: Use sliding scale to indicate the level of Pain experienced while doing the
following activity
  0=NIL 1=SLIGHT 2=MODERATE 3=SEVERE 4=Extreme
Sliding Scale 0-4 Points
(1) Walking
SLIDING SCALE 0-4 POINTS
(2) Stair climbing
SLIDING SCALE 0-4 POINTS
(3) At night while in bed
SLIDING SCALE 0-4 POINTS
(4) While resting
SLIDING SCALE 0-4 POINTS
(5) Standing
SLIDING SCALE 0-4 POINTS
STIFFNESS SCORE: What is the level of stiffness you have felt at the following times of the day 1
Sliding Scale 0-4 Points
(1) In the morning after getting up
SLIDING SCALE 0-4 POINTS
(2) Later in the day
SLIDING SCALE 0-4 POINTS
FUNCTION SCORE: What the level of difficulty felt while performing the following Activities
if you do them:

Do not answer to those activities you do not do
(Example-if you don't ride a car then do not answer 7)
Sliding Scale 0-4 Points
(1) Coming down stairs
SLIDING SCALE 0-4 POINTS
(2) Climbing stairs
SLIDING SCALE 0-4 POINTS
(3) Rising from sitting
SLIDING SCALE 0-4 POINTS
(4) Standing
SLIDING SCALE 0-4 POINTS
(5) Bending to floor
SLIDING SCALE 0-4 POINTS
(6) Walking on flat surface
SLIDING SCALE 0-4 POINTS
(7) Getting in or out of car
SLIDING SCALE 0-4 POINTS
(8) Going shopping
SLIDING SCALE 0-4 POINTS
(9) Putting on socks
SLIDING SCALE 0-4 POINTS
(10) Rising from bed
SLIDING SCALE 0-4 POINTS
(11) Taking off socks
SLIDING SCALE 0-4 POINTS
(12) Lying in bed
SLIDING SCALE 0-4 POINTS
(13) Sitting on a chair
SLIDING SCALE 0-4 POINTS
(14) Sitting on the floor
SLIDING SCALE 0-4 POINTS
(15) Getting on or off toilet
SLIDING SCALE 0-4 POINTS
(16) Heavy domestic duties
SLIDING SCALE 0-4 POINTS
(17) Light domestic duties
SLIDING SCALE 0-4 POINTS