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Table 1 Standardized assessment protocol for Health Assessment Questionnaire response categories “With some difficulty” and “With much difficulty”

From: Reported disability in relation to observed activity limitation, grip strength and physical function in women and men with rheumatoid arthritis

Activity/Question

With some difficulty

With much difficulty

3. Are you able to stand up from a chair without support?

a. With the support of one hand against the chair

a. With the support of both hands against the chair

b. Succeed on the second attempt

b. Uncertainty / fear exists

c. Succeeds only on the third attempt or more

4. Are you able to get in and out of bed?

a. Uses own technique of raising

a. Needs to take support in some way

b. Succeed on the second attempt

b. Must use a different technique than usual

c. Succeeds only on the third attempt or more

5. Are you able to cut your own meat?

The meat is replaced with half an orange. Ordinary knife is used

a. A little clumsiness

a. Greater clumsiness, dropping of utensils

b. Somewhat difficult with the grip

b. Uncoordinated cutting

c. Succeed on the second attempt

c. Very difficult to grip

d. Succeeds only on the third attempt or more

6. Can you cook your own food?

Patients prepare a soup according to recipe. Normal cooking time 10 min

a. A little clumsiness

a. Greater clumsiness, drops the utensils

b. A bit difficult with grip and handling of pans and utensils

b. Difficult to open, to lift, must exert oneself

c. Hard to open a bottle, succeeds on the second try

c. Succeeds first on third attempt or more

7. Are you able to lift a full cup or glass to your mouth?

a. A little clumsiness

a. Overflows

b. Uses an unusual grip

b. Uses both hands

8. Are you able to walk five steps down a stairway?

a. Little uncertainty exists

a. Holds on to the railing

b. Watches carefully when taking a step

b. Takes one step at a time

c. Is very uncertain/afraid

9. Are you able to walk outdoors on flat ground?

a. Pays close attention to the ground while walking

a. Very unstable

b. A little unsteady

b. Not able to walk more than 15–20 m

c. Walks with caution

c. Fear of falling exists

10. Are you able to take a bath?

Simulated in bathtub

a. A bit difficult to take the step over, succeeds on the second attempt

a. Succeeds on the third attempt to take the step over

b. Careful when he / she sits down, supports with both hands

b. Supporting oneself with both hands on the bathtub edge to get in

c. Little uncertainty

c. Very difficult to get up, succeeds on the third attempt

d. Manages to get up on the second attempt

d. Very uncertain/afraid

11. Are you able to get on and off the toilet?

a. A little cautious, looking for some support with one hand

a. Takes support with both hands

b. Manages to get up on the second attempt

b. Sits uncontrollably

c. Manages to get up on the third attempt

12. Are you able to wash and dry your body?

Simulated

a. A little clumsiness with soap and shampoo

a. Does not reach multiple body parts, >  2

b. Not able to reach everywhere (not back and feet) but almost

b. Very difficult with the balance when drying

c. Needs to sit

13. Are you able to take a 2-k bag of sugar of a shelf at head height?

a. Takes help of both hands

a. Risk of dropping the bag due to weak grip

b. Uses an unusual grip

b. Succeeds on the third attempt or more

c. Some effort succeeds on the second attempt

14. Are you able to bend over to pick up clothing from the floor?

a. Some effort

a. Losing the grip

b. Little clumsiness

b. Risk of fall

c. Succeed on the second attempt

c. Succeeds on the third attempt or more

15. Are you able to open car doors?

a. Difficulty with the grip, losing the grip, succeeding on the second attempt

a. Very heavy, using both hands

b. Little difficult, it’s heavy

b. Succeeds on the third attempt

16. Are you able to open previously opened jars?

a. Not directly, succeeds on the second attempt

a. Greater clumsiness

b. Little clumsiness

b. Uses both hands

c. Takes an unusual technique (for example holding the jar against the body)

c. Risk of dropping the jar due to the grip

17. Are you able to turn a water tap on and off?

a. Uses an unusual grip

a. Uses both hands

b. Losing the grip

b. Succeeds on the third attempt or more

c. Succeeds on the second attempt

18. Are you able to vacuum?

Tested on delimited surface, same for all patients

a. Weak grip

a. Loses the grip

b. Somewhat difficult to pull the vacuum cleaner

b. Very difficult to pull the vacuum cleaner

c. Not able to reach under low furniture

c. Takes short breaks

d. Uses an unusual technique (e.g. hose around waist)

d. Not able to reach everywhere on free surfaces

20. Are you able to get in and out of a car?

a. Uses an unusual technique

a. Sits uncontrollably

b. Some risk of hitting the head

b. Losing balance

c. Succeeds on the second attempt

c. Risk of falling

d. Great risk of hitting the head

e. Succeeds on the third attempt or more when raised