Health Assessment

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

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?

2 Wash/ Shampoo/ Soap your hair?

Score 0 - Without ANY difficulty

B Arising

3 Stand up from a staright chair?

4 Get in and out of bed?

Score 0 - Without ANY difficulty

C Eating

5 Cut your vegetables/meat?

6 Lift your Cup or glass to your mouth?

7 Open a new milk carton?

Score 1 - NO Aids and devices and help from others. With SOME difficulty

D Walking

8 Walk outdoors on a flat surface?

9 Climb up 5 steps?

Score 1 - NO Aids and devices and help from others. With SOME difficulty

E Hygiene

10 Wash and dry your body?

11 Take a Tub Bath?

12 Geton and off the toilet?

Score 2 - With Aids and devices and help from others. With MUCH difficulty

F Reach

13 Get down a 5 pound obeject from overhead?

14 Bend down and pick things from the floor?

Score 2 - With Aids and devices and help from others. With MUCH difficulty

G Grip

15 Open car doors?

16 Open jars and containers?

17 Turn Tap on and off?

Score 3 - With Aids and devices and help from others. UNABLE to do at all

H Activities

18 Run errands and shop?

19 Get in and out of Car?

20 Do chores like vaccuming or yard/garden work?

Score 3 - With Aids and devices and help from others. UNABLE to do at all

Score