BIMS LLFI

FSH BIMS LIFI

LLFI

Lower Limb Functional Index

Due to my Leg

Your lower limb (leg) may make it difficult to do some things you normally do. This list contains sentences people use to describe themselves when they have such problems. Think of yourself now or over the last few days. If an item describes you mark the box. If not leave the box blank...

I avoid heavy jobs eg. cleaning, lifting more than 5kg or 10lbs, gardening etc Never Sometimes Always I have pain almost all the time Never Sometimes Always I have difficulty with normal home or family duties and chores Never Sometimes Always I sleep less well Never Sometimes Always I need assistance with personal care eg. washing and hygiene Never Sometimes Always My regular daily activities (work, social contact) are affected Never Sometimes Always I am unable to move as fast as I would wish Never Sometimes Always I have difficulty with prolonged or extended standing Never Sometimes Always I have difficulty bending, squatting and/or reaching down Never Sometimes Always I have problems with my balance on uneven surfaces and/or with unaccustomed footwear Never Sometimes Always

PATIENT SPECIFIC INDEX - Think of 5 activities that are important to you and affected by your leg problem. If you can not think of 5, choose from those you marked in the question above. Score each activity on a scale range as follows, you may use half marks if you wish: 0= Best (Never affected / can do normal activity).....10=Worst (Always affected / Cant do activity at all)

Activity 1 Activity 1 Score 0 Best (Never affected / Can do activity normally) 1 2 3 4 5 6 7 8 9 10 Worst (Always affected / Cant do activity at all) Activity 2 Activity 2 Score 0 Best (Never affected / Can do activity normally) 1 2 3 4 5 6 7 8 9 10 Worst (Always affected / Cant do activity at all) Activity 3 Activity 3 Score 0 Best (Never affected / Can do activity normally) 1 2 3 4 5 6 7 8 9 10 Worst (Always affected / Cant do activity at all) Activity 4 Activity 4 Score 0 Best (Never affected / Can do activity normally) 1 2 3 4 5 6 7 8 9 10 Worst (Always affected / Cant do activity at all) Activity 5 Activity 5 Score 0 Best (Never affected / Can do activity normally) 1 2 3 4 5 6 7 8 9 10 Worst (Always affected / Cant do activity at all) In all your activities or work, where 100% is what you did before the injury: What is your current % of pre injury duties? (eg Workers not working, sports people not participating=0) In the last few days, as a whole person, due to your LEG, rank your overall status compared to your normal level before the injury? 0 Normal / No problem 1 2 3 4 5 Half way 6 7 8 9 10 Worst possible