Appendices – 92553 Complex Exercise Management

National Health and Nutrition Examination Survey (NHANES) Functional Status Survey

The NHANES survey is an established and routinely performed questionnaire that is designed to assess the health and nutritional status of adults and children in the United States through interviews and direct physical examinations. This particular survey focuses on functional status.

Instructor to ask: “I am going to read out some activities with which some people have some difficulty. Please tell me if you have no difficulty, some difficulty, much difficulty, are unable to do or never do these activities, when you are by yourself and without the use of aids” (read choices, probe if necessary).

Difficulty Codes

NHANES Survey

Question	Category	Question
1	DRESSING	Dress yourself including tying shoes, working zippers, and doing buttons?
2	ARISE	Stand up from an armless straight chair (such as a dining room chair)?
3	ARISE	Get in and out of bed?
4	EATING	Prepare meals?
5	EATING	Cut your meat?
6	EATING	Lift a full glass or cup to your mouth?
7	EATING	Open a new milk carton?
8	WALK	Walk a quarter mile (2-3 blocks)? If code = 0 go Q13
9	WALK	Walk from one room to another (on the same floor)?
10	WALK	Walk up and down at least 2 steps?
11	HYGIENE	Get in and out of a bathtub?
12	HYGIENE	Wash and dry your whole body?
13	HYGIENE	Get on and off the toilet?
14	DRESSING	Comb your hair?
15	REACHING	Reach and get down a 5lb object (bag of sugar) from just above your head?
16	REACHING	Bend down and pick up clothing?
17	GRIP	Open jars that have been previously opened?
18	GRIP	Use a pen or pencil to write with?
19	ERRANDS	Get in and out of a car?
20	ERRANDS	Run errands and shop?
21	ERRANDS	Do light chores such as vacuuming?
22	ERRANDS	Lift and carry a full bag of groceries?
23	ERRANDS	Do heavy chores around the house or yard (washing windows, walls, and floors)?

NHANES Scoring

The category score is the worst score the participant has for the questions in that category. For example,

Question 1: 1
Question 14: 2

Category score for Dressing (Q1, Q14) = 2

Any score of 4, 5, or 6 automatically becomes a score of 3 for the category scores. For example,

Question 2: 4 >>> 3
Question 3: 1

Category score for Arise (Q2, Q3) = 3

The Disability score is the average of the 8 categories, therefore the maximum disability score is 3

Category	Questions	Score (0-3)
Dressing	1, 14
Arise	2, 3
Eating	4, 5, 6, 7
Walking	8, 9, 10
Hygiene	11, 12, 13
Reach	15, 16
Grip	17, 18
Errands/Chores	19, 20, 21, 22, 23
Disability Score	Average of 8 Categories