| 69497-6 | Lying flat - difficulty:Find:Pt:^Patient:Ord:OPTIMAL | required |
| 69498-4 | Rolling over - difficulty:Find:Pt:^Patient:Ord:OPTIMAL | required |
| 69499-2 | Moving - lying to sitting - difficulty:Find:Pt:^Patient:Ord:OPTIMAL | required |
| 69500-7 | Sitting - difficulty:Find:Pt:^Patient:Ord:OPTIMAL | required |
| 69501-5 | Squatting - difficulty:Find:Pt:^Patient:Ord: | required |
| 69502-3 | Bending - stooping - difficulty:Find:Pt:^Patient:Ord:OPTIMAL | required |
| 69503-1 | Balancing - difficulty:Find:Pt:^Patient:Ord:OPTIMAL | required |
| 69504-9 | Kneeling - difficulty:Find:Pt:^Patient:Ord:OPTIMAL | required |
| 69505-6 | Walking - short distance - difficulty:Find:Pt:^Patient:Ord:OPTIMAL | required |
| 69506-4 | Walking - long distance - difficulty:Find:Pt:^Patient:Ord:OPTIMAL | required |
| 69507-2 | Walking - outdoors - difficulty:Find:Pt:^Patient:Ord:OPTIMAL | required |
| 69508-0 | Climbing stairs - difficulty:Find:Pt:^Patient:Ord:OPTIMAL | required |
| 69509-8 | Hopping - difficulty:Find:Pt:^Patient:Ord:OPTIMAL | required |
| 69510-6 | Jumping - difficulty:Find:Pt:^Patient:Ord:OPTIMAL | required |
| 69511-4 | Running - difficulty:Find:Pt:^Patient:Ord:OPTIMAL | required |
| 69512-2 | Pushing - difficulty:Find:Pt:^Patient:Ord:OPTIMAL | required |
| 69513-0 | Pulling - difficulty:Find:Pt:^Patient:Ord:OPTIMAL | required |
| 69514-8 | Reaching - difficulty:Find:Pt:^Patient:Ord:OPTIMAL | required |
| 69515-5 | Grasping - difficulty:Find:Pt:^Patient:Ord:OPTIMAL | required |
| 69516-3 | Lifting - difficulty:Find:Pt:^Patient:Ord:OPTIMAL | required |
| 69517-1 | Carrying - difficulty:Find:Pt:^Patient:Ord:OPTIMAL | required |
| 69519-7 | Overall level of difficulty with these activities today:Find:Pt:^Patient:Nar:OPTIMAL | required |
| 69633-6 | Total difficulty score - follow-up:Score:Pt:^Patient:Qn:OPTIMAL | optional |