Please answer the following multiple-choice questions. Your answers should regard to the past 4 weeks.

1. How would you describe the pain you usually have in your knee?
__ None
__ Very mild
__ Mild
__ Moderate
__ Severe

2. Have you had any trouble washing and drying yourself (all over) because of your knee?
__ No trouble at all
__ Very little trouble
__ Moderate trouble
__ Extreme difficulty
__ Impossible to do

3. Have you had any trouble getting in and out of the car or using public transport because of your knee?
(With or without a stick)
__ No trouble at all
__ Very little trouble
__ Moderate trouble
__ Extreme difficulty
__ Impossible to do

4. For how long are you able to walk before the pain in your knee becomes severe? (With or without a stick)
__ No pain > 60 minutes
__ 16 – 60 minutes
__ 5 – 15 minutes
__ Around the house only
__ Not at all- severe on walking

5. After a meal (sat at a table), how painful has it been for you to stand up from a chair because of your knee?
__ Not at all painful
__ Slightly painful
__ Moderately painful
__ Very painful
__ Unbearable

6. Have you been limping when walking, because of your knee?
__ Rarely, never
__ Sometimes or just at first
__ Often, not just at first
__ Most of the time
__ All of the time

7. Could you kneel down and get up again afterwards?

__ Yes, easily
__ With little difficulty
__ With moderate difficulty
__ With extreme difficulty
__ No, impossible

8. Are you troubled by pain in your knee at night in bed?
__ Not at all
__ Only one or two nights
__ Some nights
__ Most nights
__ Every night

9. How much has pain from your knee interfered with your usual work? (Including housework)
__ Not at all
__ A little bit
__ Moderately
__ Greatly
__ Totally

10. Have you felt that your knee might suddenly give away or let you down?
__ Rarely/never
__ Sometimes or just at first
__ Often, not at first
__ Most of the time
__ All the time

11. Could you do household shopping on your own?
__ Yes, easily
__ With little difficulty
__ With moderate difficulty
__ With extreme difficulty
__ No, impossible

12. Could you walk down a flight of stairs? __ Yes, easily
__ With little difficulty
__ With moderate difficulty
__ With extreme difficulty
__ No, impossible