The Duke Activity Status Index - DASI

Activity Yes No

1. Are you fully independent as for taking food, dressing, take bath or shower, use bathroom?

2. Can you freely move inside your house/apartment?

3. Can you walk one block on the straight road without stopping?

4. Can you walk up the stairs without assistance or walk up the hill?

5. Can you run short distance?

6. Can you do simple housework e.g. dust furniture or wash dishes?

7. Can you use vacuum cleaner, sweep the floor or go shopping?

8. Can you do hard housework e.g. wash the floor with a mop, lift and move heavy furniture?

9. Can you do garden work e.g. rake the foliage, operate lawn mover?

10. Can you make love and do you do it?

11. Do you play entertaining sports (tennis, soccer, volleyball, dance)?

12. Do you do hard sports (swimming, basketball, skiing)?