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WOMAC Functional Scale

This document is a questionnaire called the Western Ontario & McMaster Osteoarthritis Index (WOMAC) that assesses knee pain and physical function difficulties over the past 48 hours. It contains 17 questions divided into two sections - the first addresses knee pain during various activities, and the second addresses difficulty with daily physical activities due to knee problems. Respondents rate their pain or difficulty during each activity on a scale of none, mild, moderate, severe or extreme.

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Simon Watts
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586 views1 page

WOMAC Functional Scale

This document is a questionnaire called the Western Ontario & McMaster Osteoarthritis Index (WOMAC) that assesses knee pain and physical function difficulties over the past 48 hours. It contains 17 questions divided into two sections - the first addresses knee pain during various activities, and the second addresses difficulty with daily physical activities due to knee problems. Respondents rate their pain or difficulty during each activity on a scale of none, mild, moderate, severe or extreme.

Uploaded by

Simon Watts
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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WESTERN ONTARIO & MCMASTER OSTEOARTHRITIS INDEX

Name: Date:

1
Think of the knee pain you have experienced doing the following activities during the
last 48 hours.
Question None Mild Moderate Severe Extreme

1. Walking
2. Climbing
3. Sleeping at Night
4. Resting
5. Standing

2
Think of the difficulty you have had doing the following daily physically activities due
to your knee during the last 48 hours.
Question None Mild Moderate Severe Extreme

1. Descending stairs
2. Ascending stairs
3. Rising from sitting
4. Standing
5. Bending to the floor
6. Walking on flat surfaces
7. Getting in and out of cars, or on or off a bus
8. Going shopping
9. Putting on socks and stockings
10. Rising out of bed
11. Taking off socks and stockings
12. Lying in bed
13. Getting in and out of the bath
14. Sitting
15. Getting on or off the tiolet
16. Performing heavy domestic duties
17. Performing light domestic duties

OFFICE
USE ONLY
1 2 3 Total

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