No need to order, in my opinion. Just create a form yourself (in Word) on which the patient can indicate the score. It would look something like this:

Please indicate up to 5 activities or actions with which you have (the most) difficulties in daily life. Under each, please encircle the applicable difficulty score. Please note that 1 = as good as not difficult at all, 10 = that difficult that it is impossible to do/perform. So, the greater the difficulty, the greater number you should encircle.

I'm not sure whether this questionnaire has been validated as being as reliable as the original Visual Analogue Scale, but logic would dictate that if putting a vertical dash on a horizontal line and measuring the distance from the left is reliable, the reliability of the above system should be just as good.

This is the "official" PSQ (better: Patient-Specific Impairment Questionnaire, PSIQ) However, one should, in my opinion, add an importance score, indicating how important that activity/action is in daily life, for that particular patient. It would look like this:

1. A. Activity/action: ___________________________

B. Difficulty score: 1 2 3 4 5 6 7 8 9 10

C. Importance score: 1 2 3 4 5 6 7 8 9 10 (1 = as good as unimportant, 10 = extremely important)

2. A. Etc.

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Obviously, in the first system one just adds up the scores. In the second, the calculation would be : ([1B X 1C] + [2B X 2C] + [3B X 3C] + [4B X 4C] + [5B X 5C]). Obviously as well, the maximum scores would differ, along with the number of activities/actions. In case 5 difficulties are filled out by the patient, the maximum scores would be 50 versus 500. It is important to indicate that maximum (= scale range) in the letter to the letter-receiving party (referrer, insurance company, etc.). A bit more work (you will even have to include a sheet explaining the second system), but in my opinion the second has a substantially greater ADL (content) validity.

To all: please do send in your remarks and questions; I just developed the second system. I'm going to send in it to the Dutch PT journal, but I would like to hear your possible comments prior to that. Both positive and critical are welcome, through this newsgroup or private. (Please also note that the second system should be called the Patient-Specific Impairment & Importance Questionnaire, PSIIQ, just to avoid confusion.)

F.J.J. Conijn, PT
Editor, Physical Therapist's Literature Update
The Internet Journal of Literature Updates for Clinicians in Primary Care Orthopaedic Medicine & Rehabilitation
www.ptlitup.com