| LP134520-8 | I could walk on rough, uneven surfaces such as lawns, gravel driveway in the past 7 days | COMPONENT | 1 |
| LP134521-6 | I could walk up and down ramps or hills in the past 7 days | COMPONENT | 1 |
| LP134522-4 | I could walk up and down curbs in the past 7 days | COMPONENT | 1 |
| LP134523-2 | I could get in and out of a bus in the past 7 days | COMPONENT | 1 |
| LP134524-0 | I could walk while wearing a backpack full of books in the past 7 days | COMPONENT | 1 |
| LP134525-7 | I could do exercise that others my age can do in the past 7 days | COMPONENT | 1 |
| LP134526-5 | I could move up and down curbs using a wheelchair in the past 7 days | COMPONENT | 1 |
| LP134527-3 | I could move up and down inclines or ramps using a wheelchair in the past 7 days | COMPONENT | 1 |
| LP134528-1 | I could move on rough, uneven surfaces like lawns or gravel driveway using a wheelchair in the past 7 days | COMPONENT | 1 |
| LP134529-9 | I could move between my wheelchair and another seat such as a chair or bed in the past 7 days | COMPONENT | 1 |
| LP134530-7 | I could move around within a room, including making turns in my wheelchair in the past 7 days | COMPONENT | 1 |
| LP134531-5 | I could manage getting on and off the tub bench from a wheelchair in the past 7 days | COMPONENT | 1 |
| LP134532-3 | I could manage getting on and off the toilet from a wheelchair in the past 7 days | COMPONENT | 1 |
| LP134533-1 | I could stand up from an armless straight chair using my wheelchair in the past 7 days | COMPONENT | 1 |
| LP134534-9 | I could move on slightly uneven surfaces, cracked pavement, using a wheelchair in the past 7 days | COMPONENT | 1 |
| LP134535-6 | I could walk for 15 minutes in the past 7 days | COMPONENT | 1 |
| LP134536-4 | I could move for 30 minutes using a wheelchair in the past 7 days | COMPONENT | 1 |
| LP134537-2 | I could park a wheelchair in a narrow space like in an elevator in the past 7 days | COMPONENT | 1 |
| LP134538-0 | I could back out of an elevator in a wheelchair if there was no room to turn around in the past 7 days | COMPONENT | 1 |
| LP134539-8 | I could do a wheelie, like popping front wheels off the floor and balancing on back wheels, using my wheelchair in the past 7 days | COMPONENT | 1 |
| LP134540-6 | I could reach for a high object from my wheelchair in the past 7 days | COMPONENT | 1 |
| LP134541-4 | I could reverse direction in my wheelchair in the past 7 days | COMPONENT | 1 |
| LP134542-2 | I could open a door that faced away from my wheelchair in the past 7 days | COMPONENT | 1 |
| LP134543-0 | I could open a door that was facing my wheelchair in the past 7 days | COMPONENT | 1 |
| LP134544-8 | I could lock and unlock my wheelchair brakes in the past 7 days | COMPONENT | 1 |
| LP134545-5 | I could manage the armrests on my wheelchair | COMPONENT | 1 |
| LP134546-3 | I could manage the footrests on my wheelchair | COMPONENT | 1 |
| LP134547-1 | I could move for 15 minutes using a wheelchair in the past 7 days | COMPONENT | 1 |
| LP134548-9 | With a walking aid, I could walk for 15 minutes in the past 7 days | COMPONENT | 1 |
| LP134549-7 | With a walking aid, I could walk for 30 minutes in the past 7 days | COMPONENT | 1 |
| LP134550-5 | With a walking aid, I could walk on slightly uneven surfaces, cracked pavement in the past 7 days | COMPONENT | 1 |
| LP134551-3 | With a walking aid, I could walk on rough, uneven surfaces like lawns or gravel driveway in the past 7 days | COMPONENT | 1 |
| LP134552-1 | With a walking aid, I could walk up and down inclines or ramps in the past 7 days | COMPONENT | 1 |
| LP134553-9 | With a walking aid, I could walk up and down curbs in the past 7 days | COMPONENT | 1 |
| LP134554-7 | With a walking aid, I could open and close inside or outside doors to walk between rooms in the past 7 days | COMPONENT | 1 |
| LP134555-4 | With a walking aid, I could walk within a room in the past 7 days | COMPONENT | 1 |
| LP134556-2 | With a walking aid, I could walk across the room in the past 7 days | COMPONENT | 1 |
| LP134557-0 | With a walking aid, I could walk up stairs without holding on to anything in the past 7 days | COMPONENT | 1 |
| LP134558-8 | With a walking aid I could get in and out of a car in the past 7 days | COMPONENT | 1 |
| LP134559-6 | I was able to use my fingers to point to something in the past 7 days | COMPONENT | 1 |
| LP134560-4 | I was able to take off my socks in the past 7 days | COMPONENT | 1 |
| LP134561-2 | I was able to put on and fasten my pants by myself in the past 7 days | COMPONENT | 1 |
| LP134562-0 | I was able to button and unbutton my shirt in the past 7 days | COMPONENT | 1 |
| LP134563-8 | I was able to use a spoon to bring food up to my mouth in the past 7 days | COMPONENT | 1 |
| LP134564-6 | I was able to wipe myself thoroughly after using the toilet in the past 7 days | COMPONENT | 1 |
| LP134565-3 | I was able to pull my pants back up after using the toilet in the past 7 days | COMPONENT | 1 |
| LP134566-1 | I was able to hold a plate full of food in the past 7 days | COMPONENT | 1 |
| LP134567-9 | I was able to cut a piece of paper in half with scissors in the past 7 days | COMPONENT | 1 |
| LP134568-7 | I was able to take a shower by myself in the past 7 days | COMPONENT | 1 |
| LP134569-5 | I was able to take a bath by myself in the past 7 days | COMPONENT | 1 |