I have no limitations. I am able to do everything, including strenuous dancing and exercise.

I can dance, but at a lower level. I must guard myself and limit the amount of heavy dancing.

Light dancing is possible with occasional problems. I must avoid certain movements.

No dancing is possible. Daily activities are possible with occasional problems.

Daily activities cause moderate problems.

Daily activities cause severe problems

I feel confident that I can perform at the same level and quality as prior to my injury. I am able to articulate my limbs with 100% certainty or clarity.

I feel confident that I am almost at the same level and quality of performance as prior to my injury. I am able to articulate my limbs with 80% certainty or clarity.

I am improving but have a ways to go before I am back to the level and quality I was prior to my injury. I am able to articulate my limbs with 60% certainty or clarity.

I am improving but can only control my movement quality some of the time. I am able to articulate my limbs with 40% certainty or clarity.

I am improving but only beginning to focus on movement quality. I am able to articulate my limbs with 20% certainty or clarity.

I am improving but am working on basics and not able to focus on quality at this time.

Normal and unlimited, including hills

Slight problems, relatively unlimited distances.

Mild problems, most surfaces, up to half a mile or 10 blocks.

Moderate problems, flat surfaces, no more than 1/4 mile or 5 blocks.

Severe problems, only 1/8 mile or 2-3 blocks.

Severe problems, need cane or crutches

Normal, unlimited up and down stairs.

Slight problems, need to be careful, particularly (circle one) up / down stairs.

Mild problems, have to go slowly, particularly (circle one) up / down stairs.

Moderate problems, only 10-15 steps possible, particularly (circle one) up / down stairs.

Severe problems, require a banister for support, particularly (circle one) up / down stairs.

Severe problems, only 0-5 steps with support, especially (circle one) up / down stairs

I can do everything without symptoms of: giving out, locking, catching, grinding, or feeling weak.

I only have symptoms (of giving out, locking, catching, grinding, or feeling weak) with strenuous dancing or exercise.

I only have symptoms (of giving out, locking, catching, grinding, or feeling weak) with moderate dancing; it limits my vigorous activities.

Because I have symptoms (of giving out, locking, catching, grinding, or feeling weak) with light dancing, it limits almost all of my dancing. I occasionally have symptoms with walking or light household work.

I have symptoms frequently with simple activities such as walking. I must guard my injury at all times.

I have severe problems with symptoms (of giving out, locking, catching, grinding, or feeling weak). I can’t do much of anything without having symptoms

I have no pain.

I have occasional pain with strenuous dance or exercise. I don’t think that things are entirely back to normal. Limitations are mild and tolerable, if I am careful.

There is occasional pain with moderate dancing or light exercise.

I have pain with any dancing, exercise, or light recreational activities. Occasional pain is brought on by daily activities.

Pain is a significant problem with activities as simple as walking. The pain is relieved by rest. I can’t participate in dancing or exercise.

I have pain at all times, even during walking, standing, or light household work

Able to fully perform grand plié in all positions, including fourth and fifth.

Able to perform grand plié in first and second only.

Able to perform grand plié in second position only.

Cannot grand plié, but can demi-plié in all positions.

Have some difficulty with demi-plié.

Cannot demi-plié.

I am able to fully perform all parts of développé to the front or side without a problem.

I have slight problems performing développé to the front or side.

I have mild problems fully extending my leg in développé to the front or side, and must dèveloppé at a lower height.

I have moderate problems fully extending my leg in développé to the front or side and must mark it, but I can fully passé.

I do not développé to the front or side at all, but can do a full passé.

I cannot perform a full passé.

Able to attain and maintain my balance in relevé / pointe on the involved side without a problem.

Able to attain and maintain my balance in relevé / pointe on the involved side with only slight problems.

Able to attain and maintain my balance in relevé / pointe on the involved side with moderate difficulty.

Able to relevé but can’t maintain the balance on the involved side without barre assistance.

Able to maintain my balance on flat foot, but cannot balance in relevé.

Cannot relevé or maintain my balance on the involved side on flat foot.

Able to fully perform as much and as often as required, at 90º: grand rond de jambe en l’aire a la seconde (rotational movements of the leg in the air).

Able to perform at reduced speed: rond de jambe en l’aire a la seconde (rotational movements of the leg in the air).

Able to perform with mild problems such as reduced number and speed: rond de jambe en l’aire a la seconde (rotational movements of the leg in the air).

Able to perform with moderate problems such as reduced number, speed, and height (at 45°): rond de jambe en l’aire a la seconde (rotational movements of the leg in the air).

I mark or avoid all rond de jambe en l’aire type movements (rotational movements of the leg in the air).

I am unable to perform rond de jambe en l’aire a la seconde (rotational movements of the leg in the air) at all.

Able to fully perform floorwork or kneeling activities, without limitations.

Able to perform floorwork or kneeling activities, with mild limitations.

Able to perform floorwork or kneeling activities, with moderate limitations.

Able to perform floorwork or kneeling activities, with more moderate limitations: may require less repetitions or slight modification.

Severe problems, require support or modification.

Severe problems, unable to do

Able to fully perform unlimited multiple turns of all kinds, on either leg (to the extent you were able prior to your injury).

Able to perform, but not quite fully, turns of all kinds, on either leg (to the extent you were able prior to your injury).

Able to perform with slight problems, turns of most kinds, on either leg. I have to be careful about placement.

I have moderate problems with turning. I am able to do single inside and outside turns on the involved side.

Severe problems, no turning. I only do turn preparation and balance in releve on the involved side.

Severe problems, unable to balance on the involved side

Able to fully perform everything: all grand and petit allegro (big and small jumping) combinations, including beats (to the extent you were able prior to your injury). Take off power is normal and unlimited. Able maintain my balance when landing from a jump or hop.

Able to perform, but not quite fully, grand and petit allegro (big and small jumping) combinations (to the extent you were able prior to your injury). Take off power and ability to maintain my balance when landing is pretty good.

Able to perform with slight problems and some guarding: grand and petit allegro, and balance when landing from jumps or hops. I avoid most difficult jumps. Unable to do repeated jumps.

I have moderate problems with jumping. I am only doing simple jumps in the center.

Severe problems, affects all jumping in center floor. Can do simple jumps at the barre.

Severe problems, no jumping activity possible.

Able to fully perform all traveling combinations (change of direction, pivots, quick stops and starts, or run) at full speed.

Able to perform, but not quite fully, all traveling combinations (change of direction, pivots, quick stops and starts, or run).

Able to perform, with slight problems, traveling combinations (change of direction, pivots, quick stops and starts, or run) at reduced speed.

I have moderate problems, and must move slowly and carefully in traveling combinations (change of direction, pivots, quick stops and starts, or run).

I have severe problems, and must avoid most traveling combinations. I stick to barre and adagio (or center floor).

I avoid all traveling combinations.