CMS-P-0015A Physical_Measures

2023 MCBS Community Questionnaire

Variable Name

MR Screen Name Question Type

PXQ-Physical Measures

Question Text/Description

Code List

Routing

(01) YES
(02) NO

(01) PHONPXQ
(02) BOX PXEND

(01) IN-PERSON
(02) PHONE

(01) PHYSINTRO
(02) BOX PXEND

PHYSICAL MEASURES QUESTIONNAIRE SPECIFICATIONS
CRITERIA
INTTYPE=C001, C002, C004, C005, C006, C007, C010
SPALIVE=1
SEASON=WINTER, SUMMER
SPPROXY=SP
Other: N/A
PLACEMENT
If SEASON=WINTER and case is 11th round interview, administer after TLQ
If SEASON=SUMMER, administer after RXQ
ARE YOU CERTIFIED TO CONDUCT THE PHYSICAL MEASURES QUESTIONNAIRE (PXQ)?
PHYSCREN

PHYSCREN

code one

PHONPXQ

PHONPXQ

code one

IF YOU ARE CERTIFIED AND TRIED TO CONDUCT THE PXQ BUT THE RESPONDENT HAS REFUSED,
SELECT YES AND RECORD THE REFUSAL REASON(S) AT THE PROPER SCREENS.
IS THIS INTERVIEW BEING CONDUCTED IN-PERSON OR OVER THE PHONE?
IF R IS IN A WHEELCHAIR OR CANNOT STAND, SELECT "R CANNOT PARTICIPATE" WITHOUT READING
TEXT BELOW.

PHYSINTRO

PHYSINTRO

code one

Now I am going to ask you to do a few simple activities. Researchers are
interested in how performance on these activities relates to some of the other factors I
have asked you about in the interview.

(01) CONTINUE
(02) R CANNOT PARTICIPATE (IN WHEELCHAIR,
I will ask you to do these activities: height and weight measurements, a balance test, a walking test, a standing test, CAN’T STAND)
and a grip strength test.

(01) HGTINTRO
(02) GRPSTART - GRPSTART

My primary concern is for your safety, so I will ask you if you feel it would be safe for
you to complete each activity. I will describe these measurements and ask if you would feel comfortable and safe
completing each of the measurements. We will then complete the measurements one after the other.
Let's start by measuring your height.

HGTINTRO

HGTINTRO

code one

I will ask you to stand up straight against the wall with your feet together. Then, I will mark your height on the wall
using a sticky note and ask you to step away. I will then measure from the sticky note to the floor.
Is there any reason why you feel you cannot participate?

(01) CONTINUE
(02) R CANNOT OR WILL NOT PARTICIPATE

(01) HGTMEASU
(02) HGTREASN

(01) continuous answer
(996) TEST COULD NOT BE COMPLETED

(01) WGTINTRO
(996) HGTREASN

(01) EQUIPMENT PROBLEM
(02) NO SUITABLE SPACE TO CONDUCT THE
MEASURE
(03) R UNABLE TO UNDERSTAND INSTRUCTIONS
(04) NOT ATTEMPTED, FI FELT IT WAS UNSAFE
(05) NOT ATTEMPTED, R FELT UNSAFE
(06) NOT ATTEMPTED, R FELT UNSAFE DUE TO
COVID-19
(07) ATTEMPTED, UNABLE TO DO
(91) OTHER
(-8) DON'T KNOW
(-9) REFUSED

(01) - (07), (-8), (-9) WGTINTRO
(91) HGTREAOS

(01) Continuous answer

WGTINTRO

[IF R REFUSES TO ATTEMPT THE MEASURE, SELECT R CANNOT OR WILL NOT PARTICIATE]
HGTMEASU

HGTMEASU

verbatim text

HGTREASN

HGTREASN

code one

HGTREAOS

HGTREAOS

verbatim text

WGTINTRO

WGTINTRO

code one

RECORD HEIGHT TO THE NEAREST HALF-INCH.
[HEIGHT MUST BE RECORDED IN INCHES]

CODE THE PRIMARY REASON WHY THE TEST COULD NOT BE COMPLETED.
[IF THE RESPONDENT REFUSED TO ATTEMPT THE MEASURE, SELECT "REFUSED."]

WHAT IS THE PRIMARY REASON THE RESPONDENT CANNOT OR WILL NOT PARTICIPATE IN THIS
MEASURE?
Now, we will measure your weight.
I will ask you to stand on the scale and stand still. Once I have recorded the weight, I will ask you to step off of the
scale.
Is there any reason why you feel you cannot participate?
[IF R REFUSES TO ATTEMPT THE MEASURE, SELECT R CANNOT OR WILL NOT PARTICIATE]

WGTMEASU

WGTMEASU

verbatim text

RECORD WEIGHT TO THE NEAREST TENTH OF A POUND

(01) CONTINUE
(02) R CANNOT OR WILL NOT PARTICIPATE

(01) continuous answer
(02) R OVER SCALE MAXIMUM
(996) TEST COULD NOT BE COMPLETED

(01) WGTMEASU
(02) WGTREASN

(01) BALINTRO
(02) BALINTRO
(996) WGTREASN

Page 1 of 7

2023 MCBS Community Questionnaire

Variable Name

MR Screen Name Question Type

WGTREASN

WGTREASN

code one

WGTEXCLD

WGTEXCLD

verbatim text

BALINTRO

BALINTRO

no entry

PXQ-Physical Measures

Question Text/Description

Code List

Routing

CODE THE PRIMARY REASON WHY THE TEST COULD NOT BE COMPLETED.

(01) EQUIPMENT PROBLEM
(02) NO SUITABLE SPACE TO CONDUCT THE
MEASURE
(03) R UNABLE TO UNDERSTAND INSTRUCTIONS
(04) NOT ATTEMPTED, FI FELT IT WAS UNSAFE
(05) NOT ATTEMPTED, R FELT UNSAFE
(06) NOT ATTEMPTED, R FELT UNSAFE DUE TO
COVID-19
(07) ATTEMPTED, UNABLE TO DO
(91) OTHER
(-8) DON'T KNOW
(-9) REFUSED

(01) - (07), (-8), (-9) BALINTRO
(91) WGTEXCLD

(01) Continuous answer

BALINTRO

(01) CONTINUE
(02) R CANNOT OR WILL NOT PARTICIPATE

(01) BALPOS1
(02) BALREAS1

(01) NUMBER OF SECONDS HELD: _____
[996] TEST COULD NOT BE COMPLETED

(01) = 10 seconds, go to BALPOS2;
(01) ^=10 seconds, go to WALINTRO;
(996) BALREAS1

WHAT IS THE PRIMARY REASON THE RESPONDENT CANNOT OR WILLNOT PARTICIPATE IN THIS
MEASURE?
Next I am going to ask you to do a few simple activities for me, starting with a balance measure. Let me first
demonstrate this measure. After I demonstrate the measure, please tell me if you cannot do a particular movement
or if you feel it would be unsafe to try and do it.
[IF R REFUSES TO ATTEMPT THE MEASURE, SELECT R CANNOT OR WILL NOT PARTICIATE]
SHOW CARD PX1
DEMONSTRATE FIRST POSITION WHILE EXPLAINING POSITION
STAND WITH FEET TOGETHER, SIDE-BY-SIDE FOR 10 SECONDS
TRY NOT TO MOVE YOUR FEET
TRY TO HOLD THIS POSITION UNTIL I TELL YOU TO STOP
ASK R TO STAND IN FIRST POSITION

BALPOS1

BALPOS1

code one

ONCE R IS IN POSITION, SAY ‘BEGIN’ AND START TIMING
TIME THE FIRST POSITION
PUSH ‘START’ BUTTON WHEN YOU SAY ‘BEGIN’
PUSH ‘STOP/RESET’ BUTTON AND SAY ‘STOP’ AFTER 10 SECONDS, OR
PUSH ‘STOP/RESET’ BUTTON IF RESPONDENT STEPS OUT OF THE POSITION BEFORE 10 SECONDS
WHEN R IS IN FIRST POSITION:
Are you ready?
WHEN R IS READY, PUSH ‘START’ AND SAY:
Begin

BALREAS1

BALREAS1

code one

CODE THE PRIMARY REASON WHY THE TEST COULD NOT BE COMPLETED

BALREOS1

BALREOS1

verbatim text

OTHER (SPECIFY)

(01) EQUIPMENT PROBLEM
(02) NO SUITABLE SPACE TO CONDUCT THE
MEASURE
(03) R UNABLE TO UNDERSTAND INSTRUCTIONS
(04) NOT ATTEMPTED, FI FELT IT WAS UNSAFE
(05) NOT ATTEMPTED, R FELT UNSAFE
(06) NOT ATTEMPTED, R FELT UNSAFE DUE TO
COVID-19
(07) ATTEMPTED, UNABLE TO DO
(91) OTHER
(-8) DON'T KNOW
(-9) REFUSED
(01) [Continuous answer]

(01) - (07), (-8), (-9) WALINTRO
(91) BALREOS1

WALINTRO

Page 2 of 7

2023 MCBS Community Questionnaire

Variable Name

MR Screen Name Question Type

PXQ-Physical Measures

Question Text/Description

Code List

Routing

(01) NUMBER OF SECONDS HELD: _____
[996] TEST COULD NOT BE COMPLETED

(01) = 10 seconds, go to BALPOS3;
(01) ^= 10, go to WALINTRO
(996) BALREAS2

(01) - (07), (-8), (-9) WALINTRO
(91) BALREOS2

SHOW CARD PX2
DEMONSTRATE SECOND POSITION WHILE EXPLAINING POSITION
STAND WITH THE HEEL OF ONE FOOT TOUCHING THE SIDE OF THE BIG TOE OF THE OTHER FOOT
FOR 10 SECONDS
TRY NOT TO MOVE YOUR FEET
TRY TO HOLD THIS POSITION UNTIL I TELL YOU TO STOP
ASK R TO STAND IN SECOND POSITION
BALPOS2

BALPOS2

code one

ONCE R IS IN POSITION, SAY ‘BEGIN’ AND START TIMING
TIME THE SECOND POSITION
PUSH ‘START’ BUTTON WHEN YOU SAY ‘BEGIN’
PUSH ‘STOP/RESET’ BUTTON AND SAY ‘STOP’ AFTER 10 SECONDS, OR
PUSH ‘STOP/RESET’ BUTTON IF RESPONDENT STEPS OUT OF THE POSITION BEFORE 10 SECONDS
WHEN R IS IN SECOND POSITION:
Are you ready?
WHEN R IS READY, PUSH ‘START’ AND SAY:
Begin

BALREAS2

BALREAS2

code one

CODE THE PRIMARY REASON WHY THE TEST COULD NOT BE COMPLETED

(01) EQUIPMENT PROBLEM
(02) NO SUITABLE SPACE TO CONDUCT THE
MEASURE
(03) R UNABLE TO UNDERSTAND INSTRUCTIONS
(04) NOT ATTEMPTED, FI FELT IT WAS UNSAFE
(05) NOT ATTEMPTED, R FELT UNSAFE
(06) NOT ATTEMPTED, R FELT UNSAFE DUE TO
COVID-19
(07) ATTEMPTED, UNABLE TO DO
(91) OTHER
(-8) DON'T KNOW
(-9) REFUSED

BALREOS2

BALREOS2

verbatim text

OTHER (SPECIFY)

(01) [Continuous answer]

WALINTRO

(01) NUMBER OF SECONDS HELD: _____
[996] TEST COULD NOT BE COMPLETED

(01) go to WALINTRO
(996) BALREAS3

(01)-(07), (-8), (-9) WALINTRO
(91) BALREOS3

WALINTRO

SHOW CARD PX3
DEMONSTRATE THIRD POSITION WHILE EXPLAINING POSITION
STAND WITH THE HEEL OF ONE FOOT IN FRONT OF AND TOUCHING THE TOES OF THE OTHER FOOT
FOR 10 SECONDS
TRY NOT TO MOVE YOUR FEET
TRY TO HOLD THIS POSITION UNTIL I TELL YOU TO STOP
ASK R TO STAND IN THIRD POSITION
BALPOS3

BALPOS3

code one

ONCE R IS IN POSITION, SAY ‘BEGIN’ AND START TIMING
TIME THE THIRD POSITION
PUSH ‘START’ BUTTON WHEN YOU SAY ‘BEGIN’
PUSH ‘STOP/RESET’ BUTTON AND SAY ‘STOP’ AFTER 10 SECONDS, OR
PUSH ‘STOP/RESET’ BUTTON IF RESPONDENT STEPS OUT OF THE POSITION BEFORE 10 SECONDS
WHEN R IS IN THIRD POSITION:
Are you ready?
WHEN R IS READY, PUSH ‘START’ AND SAY:
Begin

BALREAS3

BALREAS3

code one

CODE THE PRIMARY REASON WHY THE TEST COULD NOT BE COMPLETED

(01) EQUIPMENT PROBLEM
(02) NO SUITABLE SPACE TO CONDUCT THE
MEASURE
(03) R UNABLE TO UNDERSTAND INSTRUCTIONS
(04) NOT ATTEMPTED, FI FELT IT WAS UNSAFE
(05) NOT ATTEMPTED, R FELT UNSAFE
(06) NOT ATTEMPTED, R FELT UNSAFE DUE TO
COVID-19
(07) ATTEMPTED, UNABLE TO DO
(91) OTHER
(-8) DON'T KNOW
(-9) REFUSED

BALREOS3

BALREOS3

verbatim text

OTHER (SPECIFY)

(01) [Continuous answer]

Page 3 of 7

2023 MCBS Community Questionnaire

Variable Name

MR Screen Name Question Type

PXQ-Physical Measures

Question Text/Description

Code List

Routing

(01) CONTINUE
(02) R CANNOT OR WILL NOT PARTICIPATE

(01) WALKTIM1
(02) WALKREAS1

(01) ABLE TO DO (SPECIFY SECONDS): ______
[996] TEST COULD NOT BE COMPLETED

(01) WALKTIM2
(996) WALKREAS1

(01) - (07), (-8), (-9) CSINTRO
(91) WALKOS1

Now I am going to observe how you normally walk. If you use a cane or other walking aid and you feel you need it to
walk a short distance, then you may use it. First, let me demonstrate this measure.
WALINTRO

WALINTRO

no entry

After I demonstrate the measure, please tell me if you cannot do a particular movement or if you feel it would be
unsafe to try and do it.
[IF R REFUSES TO ATTEMPT THE MEASURE, SELECT R CANNOT OR WILL NOT PARTICIATE]
USE PRE-CUT STRING TO MEASURE DISTANCE ON THE FLOOR
DEMONSTRATE THE WALK WHILE PROVIDING INSTRUCTIONS
STAND WITH TOES TOUCHING THE BEGINNING OF THE STRING
START WALKING WHEN I SAY BEGIN
WALK AT YOUR USUAL PACE
WALK PAST THE END OF THE STRING BEFORE YOU STOP

WALKTIM1

WALKTIM1

code one

ALLOW R TO USE HIS/HER WALKING AID (CANE OR WALKER)
ASK R TO STAND AT BEGINNING OF STRING
When I say “Begin” you may start walking.
PUSH ‘START’ AND SAY:
‘Begin’
PUSH ‘STOP/RESET’ WHEN ONE OF R’S FEET IS COMPLETELY ACROSS THE OTHER END OF THE STRING

WALKREAS1

WALKREAS1

code one

CODE THE PRIMARY REASON WHY THE TEST COULD NOT BE COMPLETED

(01) EQUIPMENT PROBLEM
(02) NO SUITABLE SPACE TO CONDUCT THE
MEASURE
(03) R UNABLE TO UNDERSTAND INSTRUCTIONS
(04) NOT ATTEMPTED, FI FELT IT WAS UNSAFE
(05) NOT ATTEMPTED, R FELT UNSAFE
(06) NOT ATTEMPTED, R FELT UNSAFE DUE TO
COVID-19
(07) ATTEMPTED, UNABLE TO DO
(91) OTHER
(-8) DON'T KNOW
(-9) REFUSED

WALKOS1

WALKOS1

verbatim text

OTHER (SPECIFY)

(01) [Continuous answer]

CSINTRO

(01) ABLE TO DO (SPECIFY SECONDS): ______
[996] TEST COULD NOT BE COMPLETED

(01) WALKPROB
(996) WALKREAS2

(01) EQUIPMENT PROBLEM
(02) NO SUITABLE SPACE TO CONDUCT THE
MEASURE
(03) R UNABLE TO UNDERSTAND INSTRUCTIONS
(04) NOT ATTEMPTED, FI FELT IT WAS UNSAFE
(05) NOT ATTEMPTED, R FELT UNSAFE
(06) NOT ATTEMPTED, R FELT UNSAFE DUE TO
COVID-19
(07) ATTEMPTED, UNABLE TO DO
(91) OTHER
(-8) DON'T KNOW
(-9) REFUSED

(01)-(07), (-8), (-9) CSINTRO
(91) WALKOS2

ASK RESPONDENT TO REPEAT WALK, FROM THE END OF THE STRING BACK TO THE BEGINNING OF THE
STRING
WALKTIM2

WALKTIM2

code one

When I say “Begin” you may start walking.
PUSH ‘START/STOP’ AND SAY:
‘Begin’
PUSH ‘STOP/RESET’ WHEN ONE OF R’S FEET IS COMPLETELY ACROSS THE OTHER END OF THE STRING

WALKREAS2

WALKREAS2

code one

CODE THE PRIMARY REASON WHY THE TEST COULD NOT BE COMPLETED

WALKOS2

WALKOS2

verbatim text

OTHER (SPECIFY)

WALKPROB

WALKPROB

code all

RECORD YOUR OBSERVATIONS OF THE R'S MEASURE. CHECK ALL THAT APPLY.

(01) [Continuous answer]
(01) R WALKED UNSTEADILY
(02) R LIMPED, SHUFFLED OR DRAGGED A LEG
(03) R USED A CANE
(04) R USED WALKER
(05) R STATED IT’S PAINFUL
(06) NOTHING APPLIES

CSINTRO

CSINTRO

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2023 MCBS Community Questionnaire

Variable Name

CSINTRO

SNGLCS

MR Screen Name Question Type

CSINTRO

SNGLCS

no entry

code one

PXQ-Physical Measures

Question Text/Description

Code List

Now I am going to ask you to stand up from a chair without using your arms. First, let me demonstrate this measure.
After I demonstrate the measure, please tell me if you cannot do this movement or if you feel it would be unsafe to
(01) CONTINUE
try.
(02) R CANNOT OR WILL NOT PARTICIPATE
[IF R REFUSES TO ATTEMPT THE MEASURE, SELECT R CANNOT OR WILL NOT PARTICIATE]
DEMONSTRATE CHAIR STAND WHILE PROVIDING INSTRUCTIONS
SIT IN CHAIR WITH YOUR FEET ON THE FLOOR. SIT SO THAT YOU CAN PLACE THE WIDTH OF YOUR
HANDS BETWEEN THE CHAIR AND YOUR KNEES.
FOLD YOUR ARMS ACROSS YOUR CHEST
STAND UP, KEEPING YOUR ARMS FOLDED ACROSS YOUR CHEST

Routing
(01) SNGLCS
(02) SNGLREAS

(01) R STOOD WITHOUT USING ARMS
[996] TEST COULD NOT BE COMPLETED

(01) CSINTRO2
[996] SNGLREAS

(01) EQUIPMENT PROBLEM
(02) NO SUITABLE SPACE TO CONDUCT THE
MEASURE
(03) R UNABLE TO UNDERSTAND INSTRUCTIONS
(04) NOT ATTEMPTED, FI FELT IT WAS UNSAFE
(05) NOT ATTEMPTED, R FELT UNSAFE
(06) NOT ATTEMPTED, R FELT UNSAFE DUE TO
COVID-19
(07) ATTEMPTED, UNABLE TO DO
(91) OTHER
(-8) DON'T KNOW
(-9) REFUSED

(01)-(07), (-8), (-9) GRPSTART
(91) SNGLCSOS

(01) [Continuous answer]

GRPSTART

(01) CONTINUE

RPTDCS

(01) TIME TO COMPLETE FIVE STANDS (SPECIFY
SECONDS): ______
[996] TEST COULD NOT BE COMPLETED

(01) GRPSTART
(996) CSREAS

(01) EQUIPMENT PROBLEM
(02) NO SUITABLE SPACE TO CONDUCT THE
MEASURE
(03) R UNABLE TO UNDERSTAND INSTRUCTIONS
(04) NOT ATTEMPTED, FI FELT IT WAS UNSAFE
(05) NOT ATTEMPTED, R FELT UNSAFE
(06) NOT ATTEMPTED, R FELT UNSAFE DUE TO
COVID-19
(07) ATTEMPTED, UNABLE TO DO
(91) OTHER
(-8) DON'T KNOW
(-9) REFUSED

(01)-(07), (-8), (-9) GRPSTART
(91) CSOS

(01) [Continuous answer]

GRPSTART

(01) CONTINUE
(02) R CANNOT PARTICIPATE (MISSING BOTH
HANDS)

(01) MSNGHAND
(02) BOX PXEND

(01) R IS MISSING RIGHT HAND
(02) R IS MISSING LEFT HAND
(03) CONTINUE

DOMNHAND

(01) Right
(02) Left
(03) Both hands equally dominant
(-8) DON'T KNOW
(-9) REFUSED

GRPINTRO

When I say ‘Begin’ you may stand up straight from the chair.

SNGLREAS

SNGLREAS

code one

CODE THE PRIMARY REASON WHY THE TEST COULD NOT BE COMPLETED

SNGLCSOS

SNGLCSOS

verbatim text

CSINTRO2

CSINTRO2

no entry

OTHER (SPECIFY)
Now I'm going to ask you to stand up and sit down as quickly as you can five times, keeping your arms folded
across your chest. I'm going to demonstrate one for you.
DEMONSTRATE 1 CHAIR STAND WHILE PROVIDING INSTRUCTIONS
SIT IN CHAIR WITH YOUR FEET ON THE FLOOR
FOLD YOUR ARMS ACROSS YOUR CHEST
STAND UP AND SIT DOWN ONCE
TELL R TO REPEAT THAT 4 MORE TIMES

RPTDCS

RPTDCS

code one

When I say “Begin” you may stand up.
PUSH ‘START’ AND SAY ‘Begin’
COUNT OUT LOUD AS RESPONDENT ARISES EACH TIME
PUSH ‘STOP/RESET’ WHEN R HAS COMPLETELY STOOD UP FROM THE CHAIR FOR THE 5TH TIME
STOP THE EXERCISE EARLY IF R CANNOT RISE WITHOUT USING ARMS, R IS TOO TIRED TO
CONTINUE, OR R IS UNABLE TO COMPLETE AFTER 1 MINUTE

CSREAS

CSREAS

code one

CODE THE PRIMARY REASON WHY THE TEST COULD NOT BE COMPLETED

CSOS

CSOS

verbatim text

GRPSTART

GRPSTART

code one

OTHER (SPECIFY)
IF R IS MISSING BOTH OF THEIR HANDS, SELECT "R CANNOT PARTICIPATE" WITHOUT READING TEXT
BELOW.
Now I would like to assess the strength of your hand in a gripping action.

MSNGHAND

MSNGHAND

code one

IF R IS OBVIOUSLY MISSING ONE HAND, SELECT WHICH HAND IS MISSING. IF R IS NOT OBVIOUSLY
MISSING A HAND, SELECT "CONTINUE"
IF SP IS OBVIOUSLY MISSING A HAND OR ARM, SELECT THE REMAINING HAND AND DO NOT ASK.
OTHERWISE, ASK:

DOMNHAND

DOMNHAND

code one

Which is your dominant hand?
[If Needed: Which hand do you use to hold a pencil?]

Page 5 of 7

2023 MCBS Community Questionnaire

Variable Name

MR Screen Name Question Type

PXQ-Physical Measures

Question Text/Description

Code List

Routing

(01) CONTINUE

(01) BOX PX1

Now we will measure your grip strength
We will use this machine [SHOW DYNAMOMETER] to measure how strong your hands are.
GRPINTRO

GRPINTRO

code one

You will squeeze the handle 2 times [per hand], one practice and one test trial, while your arm is at your side and
your elbow is bent like this [DEMONSTRATE 90 DEGREES].
The handle won’t move, but the machine will show how hard you squeezed. [PRESS RESET AND TEST, THEN
SQUEEZE TO DEMONSTRATE].

BOX PX1

routing

See? [SHOW RESPONDENT THE FORCE MEASUREMENT].
If MSNGHAND = 01 (RIGHT) go to LHANDPRC
Else, go to RHANDPRC
SHOW CARD PX4
Let’s practice with your RIGHT hand.
Is there any reason why you feel you cannot participate with your right hand? The items on this card list some
examples of reasons why you should not participate.
IF RESPONDENT HAS ANY OF THE CONDITIONS LISTED ON SHOWCARD PX4 FOR THEIR RIGHT HAND,
SELECT CONTINUE WITHOUT COMPLETING THE PRACTICE TRIAL

RHANDPRC

RHANDPRC

no entry

When I say ‘squeeze,’ I want you to squeeze the handle hard, but not as hard as you can.

(01) CONTINUE

(01) BOX PX2

[If Needed: We are starting with the right hand, even if you are not right handed.]
[SUPPORT DYNAMOMETER DURING PRACTICE]
Ready? 3-2-1-squeeze. [HOLD FOR 3-4 SECONDS]
Stop.

BOX PX2

routing

[PRESS RESET AND TEST ON DYNAMOMETER BEFORE CONTINUING]
If MSNGHAND = 02 (LEFT) go to RHANDTST
Else, go to LHANDPRC
SHOW CARD PX4
Let’s practice with your LEFT hand.
Is there any reason why you feel you cannot participate with your left hand? The items on this card list some
examples of reasons why you should not participate.
IF RESPONDENT HAS ANY OF THE CONDITIONS LISTED ON SHOWCARD PX4 FOR THEIR LEFT HAND,
SELECT CONTINUE WITHOUT COMPLETING THE PRACTICE TRIAL

LHANDPRC

LHANDPRC

no entry

When I say ‘squeeze,’ I want you to squeeze the handle hard, but not as hard as you can.

(01) CONTINUE

(01) BOX PX3

[SUPPORT DYNAMOMETER DURING PRACTICE.]
Ready? 3-2-1-squeeze. [HOLD FOR 3-4 SECONDS]
Stop.

BOX PX3

routing

[PRESS RESET AND TEST ON DYNAMOMETER BEFORE CONTINUING]
If MSNGHAND = 01 (RIGHT) go to LHANDTST
Else, go to RHANTST
IF RESPONDENT HAS ANY OF THE CONDITIONS LISTED ON SHOWCARD PX4 FOR THEIR RIGHT HAND,
SELECT "TEST COULD NOT BE COMPLETED" WITHOUT CONDUCTING THE TEST
Now we’re going to test your RIGHT hand. When I say ‘squeeze,’ this time I want you to squeeze the handle as
hard as you can.

RHANDTST

RHANDTST

code one

[SUPPORT DYNAMOMETER DURING TEST]
Ready? 3-2-1-squeeze! Harder, harder, harder! [HOLD FOR 3-4 SECONDS]

(01) continuous answer
(996) TEST COULD NOT BE COMPLETED

(01) BOX PX4
(996) RHDREASN

Stop.

BOX PX4

routing

[RECORD FORCE TO NEAREST TENTH OF A POUND]
[PRESS RESET AND TEST ON DYNAMOMETER]
If MSNGHAND = 02 (LEFT) go to BOX PXEND
Else, go to LHANDTST

Page 6 of 7

2023 MCBS Community Questionnaire

Variable Name

MR Screen Name Question Type

PXQ-Physical Measures

Question Text/Description

Code List

Routing

(01)-(07), (-8), (-9) BOX PX4
(91) RHDRSNOS

RHDREASN

RHDREASN

code one

REASON WHY CANNOT BE COMPLETED FOR RIGHT HAND

(01) EQUIPMENT PROBLEM
(02) NO SUITABLE SPACE TO CONDUCT THE
MEASURE
(03) R UNABLE TO UNDERSTAND INSTRUCTIONS
(04) NOT ATTEMPTED, FI FELT IT WAS UNSAFE
(05) NOT ATTEMPTED, R FELT UNSAFE
(06) NOT ATTEMPTED, R FELT UNSAFE DUE TO
COVID-19
(07) NOT ATTEMPTED, R MET EXCLUSION CRITERIA
(08) ATTEMPTED, UNABLE TO DO
(91) OTHER
(-8) DON'T KNOW
(-9) REFUSED

RHDRSNOS

RHDRSNOS

verbatim text

OTHER (SPECIFY)

(01) [Continuous answer]

BOX PX4

(01) continuous answer
(996) TEST COULD NOT BE COMPLETED

(01) BOX PXEND
(996) LHDREASN

(01) EQUIPMENT PROBLEM
(02) NO SUITABLE SPACE TO CONDUCT THE
MEASURE
(03) R UNABLE TO UNDERSTAND INSTRUCTIONS
(04) NOT ATTEMPTED, FI FELT IT WAS UNSAFE
(05) NOT ATTEMPTED, R FELT UNSAFE
(06) NOT ATTEMPTED, R FELT UNSAFE DUE TO
COVID-19
(07) NOT ATTEMPTED, R MET EXCLUSION CRITERIA
(08) ATTEMPTED, UNABLE TO DO
(91) OTHER
(-8) DON'T KNOW
(-9) REFUSED

(01)-(07), (-8), (-9) BOX PXEND
(91) LHDRSNOS

(01) [Continuous answer]

BOX PXEND

IF RESPONDENT HAS ANY OF THE CONDITIONS LISTED ON SHOWCARD PX4 FOR THEIR LEFT HAND,
SELECT "TEST COULD NOT BE COMPLETED" WITHOUT CONDUCTING THE TEST AND TURN OFF THE
DYNAMOMETER.
Now we’re going to test your LEFT hand. When I say ‘squeeze,’ this time I want you to squeeze the handle as hard
as you can.
LHANDTST

LHANDTST

code one

[SUPPORT DYNAMOMETER DURING TEST]
Ready? 3-2-1-squeeze! Harder, harder, harder! [HOLD FOR 3-4 SECONDS]
Stop.
[RECORD FORCE TO NEAREST TENTH OF A POUND]
[TURN OFF THE DYNAMOMETER]

LHDREASN

LHDREASN

code one

REASON WHY CANNOT BE COMPLETED FOR LEFT HAND

LHDRSNOS

LHDRSNOS
BOX PXEND

verbatim text
routing

OTHER (SPECIFY)
GO TO END

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