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PD Physical Activity Questionnaire
PARKINSON’S DISEASE ACTIVITY QUESTIONNAIRE
Parkinson’s Disease Research, Education and Clinical Center(PADRECC)
Michael E. DeBakey VAMC, Houston, TX
Today’s Date______Subject #______(for office use only)
We are interested in learning how patients with Parkinson’s’ disease spend their time and what types of activities (work, leisure, and self-care) they are involved with during the day. During a typical week, how many hours do you spend on the following activities?Categories: P=physical, S=social, I=Intellectual, ADL, TV. Activity Intensity= Light (Lt:<3 METS) Moderate (Mod:3-6 METS) Vigorous (Vig:>6 METS) Investigator version
Activity / METS / Category1. Dressing / 2.0 / ADL; Lt
2. Shower, bath / 2.0 / ADL; Lt
3. Grooming (shave, brush teeth, etc) / 2.0 / ADL; Lt
4. Light housework (dust, wash dishes, light cleaning, tidy house, etc. / 2.5 / P; Lt
5. Heavy housework (vacuum, scrub, mop) / 3.5 / P; Mod
6. Food preparation--cook, microwave, move about to get food / 2.5 / P; Lt
7. Laundry (load, unload, fold, hang) / 2.3 / P; Lt
8. Pay bills, keep records, write letters, etc. / 1.8 / I; Lt
9. Light repair, maintenance, fix things
(example: change light bulbs) / 3.0 / P; Mod
10. Heavy cleaning (wash car, windows, clean garage, etc. Vigorous effort) / 4.5 / P; Mod
11. Heavy home repair (paint, carpentry, use hand saw) / 4.5 / P; Mod
12. Errands outside home (bank, mall, grocery store, post office, medical appointments, etc.) / 2.3 / P; Lt
13. Gardening – general / 5.0 / P; Mod
14. Trimming shrubs or trees, manual cutter / 4.5 / P; Mod
15. Trimming shrubs or trees with power cutter, use leaf blower, edger / 3.5 / P; Mod
16. Water yard / 1.5 / P; Lt
17. Mow yard while walking / 5.5 / P; Mod
18. Mow yard using riding mower / 2.5 / P; Lt
19. Sweep, shovel, rake / 4.0 / P; Mod
20. Brisk walking / 3.8 / P; Mod
21. Slow walking, strolling / 2.5 / P; Lt
22. Swim laps / 7.0 / P; Vig
23. Lift weights / 3.0 / P; Mod
24. Water exercise, stretching, yoga,Tai Chi / 4.0 / P; Mod
25. Vigorous exercise, aerobics / 8.0 / P; Vig
26. Dancing / 3.0 / P; Mod
27. Golfing - walking / 4.5 / P; Mod
28. Golfing – using cart / 3.5 / P; Mod
29. Bowling / 3.0 / P; Mod
30. Fishing (while standing) / 3.5 / P; Mod
31. Fishing (while sitting) / 2.5 / P; Lt
32. Hunting / 5.0 / P; Mod
33. Watch TV / 1.0 / TV; Lt
34. Read / 1.3 / I; Lt
35. Crosswords, number games / 1.8 / I; Lt
36. Play musical instrument / 2.5 / I; Lt
37. Listen to music / 1.0 / I; Lt
38. Card games, board games, dominoes, bingo, etc. / 1.5 / I; Lt
39. Woodworking / 3.0 / P; Mod
40. Pool, snooker / 2.5 / P; Lt
41. Draw, paint, needlework / 2. / I; Lt
42. Computer / 1.8 / I; Lt
43. Sightseeing or travel / 2.0 / P; Mod
44. Attend church or spiritual activities / 1.5 / S; Lt
45. Movies, concerts, plays, museums, etc. / 1.5 / S; Lt
46. Attend sport event / 1.5 / S; Lt
47. Club, group meetings, senior center activities, support groups / 2.0 / S; Lt
48. Volunteer work / 2.5 / S; Lt
49. Time spent with pets and caring for them / 3.5 / S; Mod
50. Visiting with people who don’t live with you / 1.5 / S; Lt
51. Childcare – sitting / 3.0 / P; Mod
52. Childcare – standing / 3.5 / P; Mod
53. Caring for a disabled person / 4.0 / p; Mod
54.Other activities or hobbies (write in)
What were your favorite activities before you developed Parkinson’s disease? (example: fishing, gardening, reading, golfing)______
______
______
If this has changed, what are your favorite activities now?______
______
What keeps you from doing your favorite activities? (Example: too tired, too busy, Parkinson’s disease symptoms)______
______
Thank you for completing this survey