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  • Bath Ankylosing Spondylitis Functional Index Basfi

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    The document is a Bath Ankylosing Spondylitis Functional Index assessment form. It contains 10 questions about daily activities rated on a scale of easy to impossible, with the patient marking their ability for each activity over the past week. The activities include putting on socks, bending to pick up items, reaching overhead, rising from chairs and the floor, standing, climbing stairs, turning to look over the shoulder, physically demanding tasks, and completing a full day of activities.

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    BASFI

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    The document is a Bath Ankylosing Spondylitis Functional Index assessment form. It contains 10 questions about daily activities rated on a scale of easy to impossible, with the patient marking their ability for each activity over the past week. The activities include putting on socks, bending to pick up items, reaching overhead, rising from chairs and the floor, standing, climbing stairs, turning to look over the shoulder, physically demanding tasks, and completing a full day of activities.

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    © All Rights Reserved
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    462 views1 page

    Bath Ankylosing Spondylitis Functional Index Basfi

    Uploaded by

    zxzxcxzc
    The document is a Bath Ankylosing Spondylitis Functional Index assessment form. It contains 10 questions about daily activities rated on a scale of easy to impossible, with the patient marking their ability for each activity over the past week. The activities include putting on socks, bending to pick up items, reaching overhead, rising from chairs and the floor, standing, climbing stairs, turning to look over the shoulder, physically demanding tasks, and completing a full day of activities.

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    © All Rights Reserved
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    Version1 AnkSponBASFI18/09/2003.

    doc

    Bath Ankylosing Spondylitis Functional Index*


    *Calin et al. J Rheumatol 1994 21; 2281-85
    BASFI
    Date_______________

    Patient Name___________________

    Please draw a mark on each line below to indicate your ability with each of the
    following activities, during the past week:
    1. Putting on your socks or tights without help or aids (e.g. sock aids)?
    EASY

    IMPOSSIBLE
    0

    10

    2. Bending forward from the waist to pick up a pen from the floor without an aid?
    EASY

    IMPOSSIBLE
    0

    10

    3. Reaching up to a high shelf without help or aids (e.g. helping hand)?


    EASY

    IMPOSSIBLE
    0

    10

    4. Getting up out of an armless dining room chair without using your hands or any other help?
    EASY

    IMPOSSIBLE
    0

    10

    5. Getting up off the floor without any help from lying on your back?
    EASY

    IMPOSSIBLE
    0

    10

    6. Standing unsupported for 10 minutes without discomfort?


    EASY

    IMPOSSIBLE
    0
    10
    7. Climbing 12-15 steps without using a handrail or walking aid (one foot on each step)?
    EASY

    IMPOSSIBLE
    0

    10

    8. Looking over your shoulder without turning your body?


    EASY

    IMPOSSIBLE
    0

    10

    9. Doing physically demanding activities (e.g. physiotherapy exercises, gardening or sports)?


    EASY

    IMPOSSIBLE
    0

    10

    10. Doing a full day activities whether it be at home or work?


    EASY

    IMPOSSIBLE
    0

    10

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