| Speed |
Degree of Difficulty
|
Weight |
Score |
|
|
None |
Slight |
Some |
Much |
Unable |
Mph |
|
| 1. Walking 1 block
slowly? |
4 |
3 |
2 |
1 |
0 |
x1.5= |
| 2.
Walking 1 block at an average speed? |
4 |
3 |
2 |
1 |
0 |
x2.0= |
| 3. Walking 1 block quickly? |
4 |
3 |
2 |
1 |
0 |
x3.0= |
| 4. Running or jogging 1 block? |
4 |
3 |
2 |
1 |
0 |
x5.0= |
| % Score=(Sum Individual Scores/46)x100 |