Section PE [PERFORMANCE] Sequence: 27

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1 NHATS Round 4 Section PE [PERFORMANCE] Sequence: 7 PEPRE PEPRE T ON FILE Next I would like to ask {you/sp} to try to perform a few simple movements, that is to move {your/{his/her}} body in different ways. Before we start, I need to ask a few questions. PRESS AND ENTER TO CONTINUE PE pe4whhndsign R4 PE HAND USE TO SIGN YOUR NAME Which hand {do you/does SP} use to sign {your/{his/her}} name? LEFT RIGHT BOTH If PE =, set LEFTHANDED flag = (yes). If PE =, set RIGHTHANDED flag = (yes). If PE =, set EITHERHANDED flag = (yes). PE pe4surghdwrt R4 PE HAVE SURGRY TO HAND WRIST Display "in the last months" in bold underlined text. In the last months, that is since {MONTH AND YEAR MONTHS PRIOR TO TODAY S DATE}, {have you/has SP} had surgery or a serious injury on {your/{his/her}} hand or wrist? PE4 PE4 PE4 PE pe4surgyside R4 PE WHICH SIDE WAS SURGERY Which side was that (surgery or serious injury on {your/sp s} hand or wrist)? Was it the left side or right side? LEFT SIDE RIGHT SIDE Page of 7 NHATS Round :: PE

2 If PE = (left hand/wrist surgery), set LEFTGRIPTEST flag = (no). If PE = (right hand/wrist surgery), set RIGHTGRIPTEST flag = (no). If PE = (both hands/wrists surgery), set LEFTGRIPTEST flag = (no) and RIGHTGRIPTEST flag = (no). PE4 pe4flrupain R4 PE4 EXPER FLARE UP PAIN HAND Display "currently" in bold underlined text. {Are you/is SP} currently experiencing a flare-up of pain in either hand or wrist? PE6 PE6 PE6 PE5 pe4sideflrup R4 PE5 SIDE CURRNT FLARE UP PAIN Display "current" in bold underlined text. Which side is that current flare-up of pain in {your/sp s} hand or wrist? Is it the left side or right side? LEFT SIDE RIGHT SIDE If PE5 = (left hand/pain flare up), set LEFTGRIPTEST flag = (no). If PE5 = (right hand/pain flare up), set RIGHTGRIPTEST flag = (no). If PE5 = (both hands/pain flare ups), set LEFTGRIPTEST flag = (no) and RIGHTGRIPTEST flag = (no). PE6 pe4surgarmsh R4 PE6 SURGERY ARM OR SHOULDER Display "In the last months" in bold underlined text. In the last months, that is since {MONTH AND YEAR MONTHS PRIOR TO TODAY S DATE}, {have you/has SP} had surgery or a serious injury on {your/{his/her}} arm or shoulder Page of 7 NHATS Round :: PE

3 PE7 pe4sidsurgar R4 PE7 SIDE SURGERY ARM OR SHLDR Which side was that (surgery or serious injury on {your/sp s} arm or shoulder)? Was it the left side or right side? LEFT SIDE RIGHT SIDE If PE7 = (left arm/shoulder surgery), set LEFTGRIPTEST flag = (no). If PE7 = (right arm/shoulder surgery), set RIGHTGRIPTEST flag = (no). If PE7 = (both arms/shoulders surgery), set LEFTGRIPTEST flag = (no) and RIGHTGRIPTEST flag = (no). pe4surgyhips R4 SURG HIPS IN CLUD REPLCMNT Display "In the last months" in bold underlined text. In the last months, that is since {MONTH AND YEAR MONTHS PRIOR TO TODAY S DATE}, {have you/has SP} had surgery or a serious injury on {your/{his/her}} hips (including hip replacement surgery)? BOX PE BOX PE BOX PE PE9 pe4sidhipsrg R4 PE9 SIDE WAS HIP SURGERY ON Was that (surgery or serious injury on {your/sp s} hips) only on one side or on both sides? ONE SIDE If PE9 = (both hips surgery), set CHAIRSTANDS flag = (no). BOX PE BOX PE T ON FILE If MO4 = (always uses mobility device to get out of bed) or MO6 = 4 (never got out of bed by self), go to PE. Otherwise go to BOX PE. Page of 7 NHATS Round :: PE

4 PE pe4stndwhold R4 PE STAND WITHOUT HOLDING ON Display "stand without holding onto anyone or anything" in bold underlined text. For a few of the body movements, I will ask {you/sp} to stand without holding onto anyone or anything. I can help {you/{him/her}} get up if {you/{he/she}} would like me to. {Are you/is SP} able to try this? If PE = (not able to stand without holding on to anyone/anything), set BALANCESTANDS flag = (no). BOX PE BOX PE T ON FILE If CHAIRSTANDS flag = (), go to PE. Otherwise, go to PE. PE pe4upchbyslf R4 PE GET UP OUT CHAIR BY SELF Display "without" and "by {yourself/{himself/herself}}" in bold underlined text. If CANE flag = (yes) or WALKER flag = (yes), display and without {your/{his/her}} {cane/walker/cane or walker}. If CANE flag = (yes) and WALKER flag is null, display cane. If WALKER flag = (yes) and CANE flag is null, display walker. If CANE flag = (yes) and WALKER flag = (yes), display cane or walker. I will also ask {you/sp} to get up out of a chair by {yourself/{himself/herself}} {and without {your/{his/her}} {cane/walker/cane or walker}}. {Are you/is SP} able to try this? If PE = (unable to try getting up from chair without mobility devices/help), set CHAIRSTANDS flag = (no). BOX PE BOX PE T ON FILE If MO5 = (used wheelchair every time to get around home/building) or MO6 = (used scooter every time to get around home/building) set WALKING COURSE flag = no () and go to PE4. Otherwise go to PE. PE pe4wlkdsself R4 PE WALK SHORT DIST BY SELF Page 4 of 7 NHATS Round :: PE

5 Display "walk a short distance in this room by {yourself/{himself/herself}}" in bold underlined text. If MO =,,, or 4 (used cane every time, most times, sometimes, or rarely when walking around inside) or MO4 =,,, or 4 (used walker every time, most times, sometimes, or rarely when walking around inside), display {You/{He/She}} may use {your/{his/her}} {cane/walker/cane or walker} if {you feel/{he/she} feels} {you need/{he/she} needs} it to walk a short distance. If MO =,,, or 4 and MO4,,, or 4, display cane. If MO4 =,,, or 4 and MO,,, or 4, display walker. If MO =,,, or 4 and If MO4 =,,, or 4, display cane or walker. I will (also) be asking {you/sp} to walk a short distance in this room by {yourself/{himself/herself}}. {{{You/{He/She}} may use {your/{his/her}} {cane/walker/cane or walker} if {you feel/{he/she} feels} {you need/{he/she} needs} it to walk a short distance.} {Are you/is SP} able to try this? If PE = (unable to walk short distance), set WALKINGCOURSE flag = (no). PE4 PE4 T ON FILE Display "ACTIVITIES TO SET UP AND DEMONSTRATE in bolded text. Display grid with 7 rows and columns. In RC, use null display. In RC, display ACTIVITY in bolded text. In RC, display ADMINISTER in bolded text. In RC, display.. In RC, display BALANCE STANDS. In RC, if BALANCESTANDS flag = (no), set BALANCESTANDSELIG flag = (), and display. Otherwise, set BALANCESTANDSELIG flag = (), and display. In RC, display.. In RC, display WALKING COURSE. In RC, if WALKINGCOURSE flag = (no), set WALKINGCOURSELIG flag = (), and display. Otherwise, set WALKINGCOURSELIG flag = (), and display. In R4C, use null display. In R4C, use null display. In R4C: If WALKINGCOURSELIG flag = () and [MO =,, or 4 (used cane most times, sometimes, or rarely inside) or MO4 =,, or 4 (used walker most times, sometimes, or rarely inside)], set AIDUSAGE flag = (SOMETIMES), and display B. SOMETIMES USES CANE/WALKER AROUND HOME. Else, if WALKINGCOURSELIG flag = () and [MO = (used cane every time inside) or MO4 = (used walker every time inside)], set AIDUSAGE flag = (ALWAYS), and display C. ALWAYS USES CANE/WALKER AROUND HOME. Otherwise, if WALKINGCOURSELIG flag = (), set AIDUSAGE flag = (NEVER), and display A. DOESN T USE CANE/WALKER AROUND HOME. In R5C, display.. Page 5 of 7 NHATS Round :: PE

6 In R5C, display CHAIR STANDS. In R5C, if CHAIRSTANDS flag = (no), set CHAIRSTANDSELIG flag = (), and display. Otherwise, set CHAIRSTANDSELIG flag = (), and display. In R6C, display 4.. In R6C, display GRIP STRENGTH. In R6C: If LEFTGRIPTEST flag= (no) and RIGHTGRIPTEST flag= (no), set GRIPSTRENGTHELIG flag = (), and display "". Else if LEFTGRIPTEST flag= (no) and RIGHTGRIPTEST flag NE (no), set GRIPSTRENGTHELIG flag = ( RIGHT), and display " RIGHT". Else if LEFTGRIPTEST flag NE (no) and RIGHTGRIPTEST flag= (no), set GRIPSTRENGTHELIG flag = ( LEFT), and display " LEFT". Else if [LEFTGRIPTEST flag NE () and RIGHTGRIPTEST flag NE (no)] and [LEFTHANDED flag = ()], set GRIPSTRENGTHELIG flag = ( LEFT), and display " LEFT". Otherwise, set GRIPSTRENGTHELIG flag = ( RIGHT), and display " RIGHT". Display TRANSFER INFORMATION TO FRONT PAGE OF ACTIVITIES BOOKLET Display AFTER ACTIVITIES ARE COMPLETED, PRESS AND ENTER TO CONTINUE ACTIVITIES TO SET UP AND DEMONSTRATE ACTIVITY BALANCE STANDS WALKING COURSE CHAIR STANDS GRIP STRENGTH ADMINISTER {/} {/} {A. DOESN T USE CANE/WALKER AROIUND HOME/ B. SOMETIMES USES CANE/WALKER AROUND HOME/ C. ALWAYS USES CANE/WALKER AROUND HOME} {/} { RIGHT/ LEFT/} TRANSFER INFORMATION TO FRONT PAGE OF ACTIVITIES BOOKLET AFTER ACTIVITES ARE COMPLETED, PRESS AND ENTER TO CONTINUE PE5 PE5 T ON FILE REMEMBER TO AFFIX SP ID LABEL AND WRITE YOUR INTERVIEWER ID AND DATE ON ACTIVITIES BOOKLET COVER. PRESS AND ENTER TO CONTINUE Go to Section HW Height & Weight Flag Variables Set in PE Section fl4lefthand fl4righthand fl4eiherhand R4 F PE CAN SP DO LEFT HAND TEST R4 F PE CAN SP DO RGT HAND TEST R4 F PE CAN SP DO EITHR HAND TST Page 6 of 7 NHATS Round :: PE

7 fl4lftgrptst fl4rhtgrptst fl4charstnds fl4balstands fl4wlkingrse R4 F PE CAN SP DO LFT GRIP TEST R4 F PE CAN SP DO RIGHT GRIP TEST R4 F PE CAN SP DO CHAIR STANDS R4 F PE CAN SP DO BALANCE STANDS R4 F PE CAN SP DO WALKING COURSE Page 7 of 7 NHATS Round :: PE

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