Function with lower-extremity musculoskeletal disorders. Free to use.
LEFS (Lower Extremity Functional Scale) is a validated clinical instrument used to assess function with lower-extremity musculoskeletal disorders. The instrument contains 20 items.
Source / attribution: Binkley JM et al. Phys Ther. 1999;79(4):371-383.
The instrument's primary construct — function with lower-extremity musculoskeletal disorders — is operationalized through a fixed set of items, each with a defined response format. This standardisation is what allows LEFS scores to be compared meaningfully across clinicians, sites, and studies.
Like all screening or assessment instruments, LEFS is a structured aid — not a diagnostic test in isolation. Results should be interpreted alongside history, examination, and clinical context. Where a score crosses an actionable threshold, the next step is typically a more detailed clinical evaluation rather than a definitive diagnosis.
Answer all 20 items below to see your LEFS score and interpretation.
Each item is scored on a 5-point scale (0–4). Your score updates live as you answer.
All scoring runs in your browser. No data is sent anywhere — close the tab and the answers are gone.
LEFS uses simple summation: each item's selected response is converted to a numeric value, and the values are added to produce a total score. Reverse-scored items are inverted before summation.
Scoring notes: MCID ≈ 9 points; higher scores indicate better function.
The cutoffs below are drawn from the published validation literature. Always interpret in clinical context.
| Score range | Band | Interpretation |
|---|---|---|
| 0–20 | Severe limitation | Significant restriction in lower-extremity function. |
| 21–40 | Moderate limitation | Marked restriction; structured rehab indicated. |
| 41–60 | Mild limitation | Some difficulty with demanding activities. |
| 61–80 | Minimal limitation | Near-normal lower-extremity function. |
This is an illustrative walkthrough, not a real patient. Follow the same four steps with your own answers — or use the live calculator at the top of this page.
Read each question and choose the response that best fits. Each response has a number next to it — that number is the item's score. The example below uses illustrative answers.
| # | Item | Example response | Score |
|---|---|---|---|
| 1 | Any of your usual work, household, or school activities | Moderate difficulty | 2 |
| 2 | Your usual hobbies, recreational, or sporting activities | Moderate difficulty | 2 |
| 3 | Getting into or out of the bath | Quite a bit | 1 |
| 4 | Walking between rooms | Moderate difficulty | 2 |
| 5 | Putting on your shoes or socks | Quite a bit | 1 |
| 6 | Squatting | Moderate difficulty | 2 |
| 7 | Lifting an object, like a bag of groceries from the floor | Quite a bit | 1 |
| 8 | Performing light activities around your home | Moderate difficulty | 2 |
| 9 | Performing heavy activities around your home | Quite a bit | 1 |
| 10 | Getting into or out of a car | Moderate difficulty | 2 |
| 11 | Walking 2 blocks | Quite a bit | 1 |
| 12 | Walking a mile | Moderate difficulty | 2 |
| 13 | Going up or down 10 stairs (about one flight) | Quite a bit | 1 |
| 14 | Standing for one hour | Moderate difficulty | 2 |
| 15 | Sitting for one hour | Quite a bit | 1 |
| 16 | Running on even ground | Moderate difficulty | 2 |
| 17 | Running on uneven ground | Quite a bit | 1 |
| 18 | Making sharp turns while running fast | Moderate difficulty | 2 |
| 19 | Hopping | Quite a bit | 1 |
| 20 | Rolling over in bed | Moderate difficulty | 2 |
Add up all the item scores you noted in Step 1.
2 + 2 + 1 + 2 + 1 + 2 + 1 + 2 + … (items 9–20 sum to 18) = 31
Find the row in the interpretation table whose range contains your total:
Total = 31 falls between 21 and 40 → Moderate limitation
Moderate limitation. Marked restriction; structured rehab indicated.
A score is one input alongside history and examination. LEFS supports clinical judgment — it does not replace it.
If LEFS doesn't fit your context, related instruments in orthopaedics include:
| Scale | Measures | Items | Time |
|---|---|---|---|
| ODI | Self-reported low-back-pain functional disability | 10 | — |
| NDI | Self-reported neck-pain functional disability | 10 | — |
| Oxford Knee Score | Pain and function after total knee replacement | 12 | — |
| Oxford Hip Score | Pain and function after total hip replacement | 12 | — |
| BASFI | Functional limitation in ankylosing spondylitis | 10 | — |
| IPSS | Lower-urinary-tract symptoms in men | 7 | — |
| IIEF-5 / SHIM | Erectile dysfunction screen | 5 | — |
| DLQI | Skin-disease impact on health-related quality of life | 10 | ≈ 2 minutes |
LEFS (Lower Extremity Functional Scale) is a validated instrument that assesses function with lower-extremity musculoskeletal disorders.
LEFS contains 20 items. Items are summed to produce a total score.
Scores of 61–80 fall in the "Minimal limitation" band. Near-normal lower-extremity function.
Scores of 0–20 fall in the "Severe limitation" band. Significant restriction in lower-extremity function.
Yes — LEFS is in the public domain and free for clinical, educational, and research use without permission.
Binkley JM et al. The Lower Extremity Functional Scale (LEFS). Phys Ther. 1999;79(4):371-383.
No. LEFS is a structured assessment aid. A score is one input alongside history, examination, and clinical context. Treatment decisions should never rest on a screening score alone.
LEFS is supported by the following peer-reviewed sources: