NRS BASFI Date Name (Data from completed questionnaires will not be stored.) Impossible Easy   10. Doing a full-day's activities, whether it be at home or at work. Impossible Easy   9. Doing physically demanding activities (e.g. physiotherapy exercises, gardening or sports). Impossible Easy   8. Looking over your shoulder without turning your body. Impossible Easy   One foot at each step. 7. Climbing 12-15 steps without using a handrail or walking aid.           Impossible Easy ImpossibleEasy ImpossibleEasy ImpossibleEasy Impossible Easy Impossible Easy 6. Standing unsupported for 10 minutes without discomfort. 5. Getting up off the floor without help from lying on your back. 4. Getting up out of an armless dining room chair without using your hands or any other help. 3. Reaching up to a high shelf without help or aids (e.g. helping hand). 2. Bending forward from the waist to pick up a pen from the floor without an aid. Please indicate your level of ability with each of the following activities during the last week. 1. Putting on your socks or tights without help or aids (e.g. sock aid).