The following items are about activities you might do during a typical day. Does your health limit you in these activities? If so, how much?

a) Vigorous activities, such as running, lifting heavy objects,
participating in strenuous sports
b) Moderate activities, such as moving a table, pushing a
vacuum cleaner, bowling, or playing golf
c) Lifting or carrying groceries
d) Climbing several flights of stairs
e) Climbing one flight of stairs
f) Bending, kneeling or stooping
g) Walking more than one mile
h) Walking half a mile
i) Walking 100 yards
j) Bathing or dressing yourself

Yes, limited a lot
Yes, limited a little
No, not limited at all