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Joint and muscle condition questionnaire

 

You have already completed the assessment. Here are your scores.

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    Dreadful                                          Good

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  0 1 2 3 4 5 6 7 8 9 10    

1.       Lower back. Rate the current condition of your lower back.

                             
  0 1 2 3 4 5 6 7 8 9 10    

2.      Upper back. Rate the current condition of your upper back.

                             
  0 1 2 3 4 5 6 7 8 9 10    

3.      Neck. Rate the current condition of your neck.

                             
  0 1 2 3 4 5 6 7 8 9 10    

4.      Right shoulder. Rate the current condition of your right shoulder.

                             
  0 1 2 3 4 5 6 7 8 9 10    

5.      Left shoulder. Rate the current condition of your left shoulder.                      

                             
  0 1 2 3 4 5 6 7 8 9 10    

6.      Right wrist. Rate the current condition of your right wrist and hand.

                             
  0 1 2 3 4 5 6 7 8 9 10    

7.      Left wrist. Rate the current condition of your left wrist and hand.           

                             
  0 1 2 3 4 5 6 7 8 9 10    

8.      Right hip. Rate the current condition of your right hip.

                             
  0 1 2 3 4 5 6 7 8 9 10    

9.      Left hip. Rate the current condition of your left hip.

                             
  0 1 2 3 4 5 6 7 8 9 10    

10.    Right knee. Rate the current condition of your right knee.

                             
  0 1 2 3 4 5 6 7 8 9 10    

11.    Left knee. Rate the current condition of your left knee.

                             
  0 1 2 3 4 5 6 7 8 9 10    

12.    Right lower leg. Rate the current condition of your lower leg, and foot.

         Do you suffer from shin splints, Achilles tendonitis …

                             
  0 1 2 3 4 5 6 7 8 9 10    

13.    Left lower leg. Rate the current condition of your lower leg, and foot.

         Do you suffer from shin splints, Achilles tendonitis …

                             
  0 1 2 3 4 5 6 7 8 9 10    

14.    Right foot. Rate the current condition of your right foot.

        Do you suffer from heel pain, plantar fasciitis, malformed toes ….

                             
  0 1 2 3 4 5 6 7 8 9 10    

 

15.    Left foot. Rate the current condition of your left foot.

 

        Do you suffer from heel pain, plantar fasciitis, malformed toes ….

 

                               
  0 1 2 3 4 5 6 7 8 9 10    

 

 

 

 

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