Preventing Chronic Disability from Low Back Pain RENAISSANCE ...

B. DISABILITY ASSESSMENT: DEGREES OF RESULTING
DISABILITY
The degrees of resulting disability are depicted on this ability/disability profile,
which affords a readily visible and reasonably accurate portrait, not only of
resulting disability but also and very importantly of, residual functional capacity.
The degrees of disability are estimated as follows:
Normal Mild Moderate Severe Profound
0-5% 5-20% 20-50% 50-75% 75-100%
Mental Health ❏ ❏ ❏ ❏ ❏
Learning/Intelligence ❏ ❏ ❏ ❏ ❏
Consciousness/Seizures ❏ ❏ ❏ ❏ ❏
Balance/Co-ordination ❏ ❏ ❏ ❏ ❏
Vision ❏ ❏ ❏ ❏ ❏
Hearing ❏ ❏ ❏ ❏ ❏
Speech ❏ ❏ ❏ ❏ ❏
Continence ❏ ❏ ❏ ❏ ❏
Reaching ❏ ❏ ❏ ❏ ❏
Lifting/Carrying ❏ ❏ ❏ ❏ ❏
Manual Dexterity ❏ ❏ ❏ ❏ ❏
Bend/Kneel/Squat ❏ ❏ ❏ ❏ ❏
Sitting ❏ ❏ ❏ ❏ ❏
Standing ❏ ❏ ❏ ❏ ❏
Climbing Stairs ❏ ❏ ❏ ❏ ❏
Walking ❏ ❏ ❏ ❏ ❏
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