IF often troubled with pain: HePain = 1  
|
| HePaa  
| How bad is the pain most of the time? Is it ...READ OUT...  
| 1 mild,  
| 2 moderate,  
| 3 or, severe?  
|
| HePab  
| How would you rate your pain if you were walking on a flat surface?  
| Please rate your pain from 0-10 for each of the following where 0  
| is no pain and 10 is severe or excruciating pain, as bad as you can  
| imagine.  
| 1 Press 1 and enter to continue  
| 2 Can't walk or never walks  
|
| IF can walk: HePab = 1  
| |  
| | HeBck  
| | (How would you rate the pain) in your back?  
| | PROMPT IF NECESSARY: Where 0 is no pain and 10 is severe or  
| | excruciating pain, as bad as you can imagine  
| | Range: 0..10  
| |  
| | HeHip  
| | (How would you rate the pain) in your hips?  
| | PROMPT IF NECESSARY: Where 0 is no pain and 10 is severe or  
| | excruciating pain, as bad as you can imagine  
| | Range: 0..10  
| |  
| | HeKne  
| | (How would you rate the pain) in your knees?  
| | PROMPT IF NECESSARY: Where 0 is no pain and 10 is severe or  
| | excruciating pain, as bad as you can imagine  
| | Range: 0..10  
| |  
| | HeFet  
| | (How would you rate the pain) in your feet?  
| | PROMPT IF NECESSARY: Where 0 is no pain and 10 is severe or  
| | excruciating pain, as bad as you can imagine  
| | Range: 0..10  
| |  
| ENDIF  
|
ENDIF  
IF can walk: HePab <> 2  
|
| HeBal  
| SHOW CARD J  
| How often do you have problems with keeping your balance when you  
| are walking on a level surface?  
| 1 Always  
| 2 Very often  
| 3 Often