Tegner Activity Score Form PDF Details

Activity plays a key role in the rehabilitation of patients after surgery. A tool called the Tegner Activity Score allows professionals to measure and monitor activity levels in their postoperative patients – providing valuable information that can be used to guide treatment decisions. The Tegner Activity Score form is an easy-to-use method for quantifying physical activity before and after surgery, as well as patient responses to it. In this blog post, we’ll discuss what the Tegner Activity Score measures, why it’s important for rehabilitating patients, how to use it effectively during treatment sessions, and more!

QuestionAnswer
Form NameTegner Activity Score Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namestegner score 日本語, tegner scale, tegner activity score pdf, tegner activity scale

Form Preview Example

TEGNER ACTIVITY LEVEL SCALE

Please indicate in the spaces below the HIGHEST level of activity that you participated in BEFORE YOUR INJURY and the highest level you are able to participate in CURRENTLY.

BEFORE INJURY: Level__________

CURRENT: Level___________

 

 

 

 

Level 10

Competitive sports- soccer, football, rugby (national elite)

 

Level 9

Competitive sports- soccer, football, rugby (lower divisions), ice hockey,

 

 

wrestling, gymnastics, basketball

 

Level 8

Competitive sports- racquetball or bandy, squash or badminton, track and

 

 

field athletics (jumping, etc.), down-hill skiing

 

Level 7

Competitive sports- tennis, running, motorcars speedway, handball

 

 

Recreational sports- soccer, football, rugby, bandy, ice hockey, basketball,

 

 

squash, racquetball, running

 

Level 6

Recreational sports- tennis and badminton, handball, racquetball, down-hill

 

 

skiing, jogging at least 5 times per week

 

Level 5

Work- heavy labor (construction, etc.)

 

 

Competitive sports- cycling, cross-country skiing,

 

 

Recreational sports- jogging on uneven ground at least twice weekly

 

Level 4

Work- moderately heavy labor (e.g. truck driving, etc.)

 

Level 3

Work- light labor (nursing, etc.)

 

Level 2

Work- light labor

 

 

 

Walking on uneven ground possible, but impossible to back pack or hike

 

Level 1

Work- sedentary (secretarial, etc.)

 

Level 0

Sick leave or disability pension because of knee problems

Y Tegner and J Lysolm. Rating Systems in the Evaluation of Knee Ligament Injuries. Clinical Orthopedics and Related Research. Vol. 198: 43-49, 1985.

SURGI CAL HI STORY

Have you had any additional surgeries to your knee other than those performed by Dr. Stone?

Yes / No

If Yes:

What procedure(s) were performed?

When was the surgery performed?

Who performed the surgery?