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Pain Program Activity/updates
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Walking interference 1-10 choose
• • •
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Sit ability choose 1-10
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Stand ability choose 1-10
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ADL's ability choose 1-10
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Mood interfere choose 1-10
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Normal Work choose 1-10
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Sleep ability choose 1-10
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Family interfere choose 1-10
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Spouse interfere choose 1-10
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Social activ. interf choose1-10
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Life Enjoy choose 1-10
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Update #1
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Walk update1 choose 1-10
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Describe changes
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Sitting re-eval choose 1-10
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Describe changes
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Stand re-eval choose 1-10
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Describe changes
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ADL update1 choose 1-10
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Describe changes
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Mood upd1 choose 1-10
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Describe changes
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Norm work upd1 choose 1-10
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Describe changes
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Sleep Upd1 choose 1-10
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Describe changes
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Fam Relat Upd1 choose 1-10
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Describe changes
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Spouse update #1 choose 1-10
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Describe changes
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Social Update#1 choose 1-10
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Describe changes
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Life enjoy upd#1 choose 1-10
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Describe changes
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