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In the past 2 weeks, how difficult was it to clip your toenails?
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In the past 2 weeks, how difficult was it to get to the toilet on time?
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In the past 2 weeks, how difficult was it to control your bladder (not have an accident)?
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In the past 2 weeks, how difficult was it to control your bowels (not have an accident)?
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In the past 2 weeks, how difficult was it to do light household tasks/chores (e.g., dust, make a bed, take out garbage, do the dishes)?
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In the past 2 weeks, how difficult was it to go shopping?
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In the past 2 weeks, how difficult was it to do heavy household chores (e.g., vacuum, laundry or yard work)?
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In the last 6 months, have you had a painful episode severe enough to keep you from doing the usual daily activities, but without being seen by a doctor?
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In the past 2 weeks, how difficult was it to stay sitting without losing your balance?
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In the past 2 weeks, how difficult was it to stay standing without losing your balance?
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In the past 2 weeks, how difficult was it to walk without losing your balance?
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In the past 2 weeks, how difficult was it to move from a bed to a chair?
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In the past 2 weeks, how difficult was it to walk one block?
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In the past 2 weeks, how difficult was it to walk fast?
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In the past 2 weeks, how difficult was it to climb one flight of stairs?
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In the past 2 weeks, how difficult was it to climb several flights of stairs?
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In the past 2 weeks, how difficult was it to get in and out of a car?
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In the past 2 weeks, how difficult was it to use your hand that was most affected by your stroke to carry heavy objects (e.g., a bag of groceries)?
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In the past 2 weeks, how difficult was it to use your hand that was most affected by your stroke to turn a doorknob?
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In the past 2 weeks, how difficult was it to use your hand that was most affected by your stroke to open a can or jar?