| Distance |
Degree of Difficulty
|
Weight |
Score |
|
|
None |
Slight |
Some |
Much |
Unable |
Feet |
|
| 1. Walking indoors such as around your
home? |
4 |
3 |
2 |
1 |
0 |
x20= |
| 2.
Walking 50 feet? |
4 |
3 |
2 |
1 |
0 |
x50= |
3. Walking 150
feet ( block)? |
4 |
3 |
2 |
1 |
0 |
x150= |
| 4.
Walking 300 feet (1 block)? |
4 |
3 |
2 |
1 |
0 |
x300= |
| 5.
Walking 600 feet (2 blocks)? |
4 |
3 |
2 |
1 |
0 |
x600= |
| 6.
Walking 900 feet (3 blocks)? |
4 |
3 |
2 |
1 |
0 |
x900= |
| 7.
Walking 1500 feet (5 blocks)? |
4 |
3 |
2 |
1 |
0 |
x1500= |
| % Score=(Sum Individual Scores/14 080)x100 |