Disability Index Questionnaire

Please write down your current PDI score

Javascript is disabled

Javascript is disabled on your browser. Please enable it in order to use this form.

Pain Disability Index

We would like to know how much your pain is preventing you from doing what you would normally do.
For each of the 7 categories listed, please select the number which best describes your current status. A score of 0 signifies no disability at all and a score of 10 means total disability.

Family/Home Responsibilities. This includes chores and duties performed around the house (e.g., yard work) and errands or favours for other family members (e.g., driving the children to school).*

Recreation. This includes hobbies, sports, and other leisure time / fun activities.*

Social Activities. This refers to activities that involve participation with friends other than family members. It includes parties, theatre, concerts, dining out, and other social functions.*

Occupation. This refers to activities that are a part of, or directly related to, your job. This includes nonpaying jobs as well, such as that of a homemaker or volunteer worker.*

Sexual Behaviour. This refers to the frequency and quality of one's sex life.*

Self Care. This includes personal maintenance and independent daily living activities such as getting dressed, taking a shower, driving, etc.*

Life-support Activities. This refers to basic life supporting behaviours such as eating, sleeping and breathing.*

Total Score:

0 / 70

Important

Please write down your PDI score in your FORM before your click on DONE!

Minimal Clinically Important Change (MCIC)= 9

You will do this PDI questionnaire again in 6 weeks to evaluate your progress with this program.

Please click here to go back to questionnaires.

Server Side Error

We faced problems while connecting to the server or receiving data from the server. Please wait for a few seconds and try again.

If the problem persists, then check your internet connectivity. If all other sites open fine, then please contact the administrator of this website with the following information.

TextStatus: undefined
HTTP Error: undefined

Processing your request

Error

Some error has occured.