Self Reporting of Myelopathy Scales Self-Reported mJOA and Nurick To be completed by patients Question Title * 1. With regards the function of your hands? I am unable to move my hands at all I am not able to eat with a spoon, but I can move my hands I am not able to do up my shirt buttons, but I can eat with a spoon I am able to button my shirt, but it is extremely difficult I am able to button my shirt with slight difficulty My hands are unaffected Question Title * 2. How easy was question 1 to complete, on a scale of 1 to 10? 1 (Very difficult) 2 3 4 5 (OK) 6 7 8 9 10 (Very easy) How easy was that? How easy was that? 1 (Very difficult) How easy was that? 2 How easy was that? 3 How easy was that? 4 How easy was that? 5 (OK) How easy was that? 6 How easy was that? 7 How easy was that? 8 How easy was that? 9 How easy was that? 10 (Very easy) Question Title * 3. With regards your legs? I am unable to feel or move my legs I can feel my legs, but I cannot move them I am able to move my legs but I cannot walk I can walk, but I require a walking aid and only on the flat I can walk up and down stairs, but I must hold on to the handrail I can walk up and down stairs without holding onto the handrail I can walk unaided, with only a mild instability My walking is unaffected Question Title * 4. How easy was question 3 to complete, on a scale of 1 to 10? 1 (Very difficult) 2 3 4 5 (OK) 6 7 8 9 10 (Very easy) How easy was that? How easy was that? 1 (Very difficult) How easy was that? 2 How easy was that? 3 How easy was that? 4 How easy was that? 5 (OK) How easy was that? 6 How easy was that? 7 How easy was that? 8 How easy was that? 9 How easy was that? 10 (Very easy) Question Title * 5. With regards the feeling in your hands? I have no feeling in my hands I have significant loss of feeling (incl. numbness, tingling) or pain in my hands I have mild loss of feeling (incl. numbness, tingling) in my hands I have normal feeling in my hands Question Title * 6. How easy was question 5 to complete, on a scale of 1 to 10? 1 (Very difficult) 2 3 4 5 (OK) 6 7 8 9 10 (Very easy) How easy was that? How easy was that? 1 (Very difficult) How easy was that? 2 How easy was that? 3 How easy was that? 4 How easy was that? 5 (OK) How easy was that? 6 How easy was that? 7 How easy was that? 8 How easy was that? 9 How easy was that? 10 (Very easy) Question Title * 7. With regards your bladder? I am unable to voluntarily pass urine I have marked difficulty in starting to pass urine I have mild difficulty in starting to pass urine My bladder function is unaffected Question Title * 8. How easy was question 7 to complete, on a scale of 1 to 10? 1 (Very difficult) 2 3 4 5 (OK) 6 7 8 9 10 (Very easy) How easy was that? How easy was that? 1 (Very difficult) How easy was that? 2 How easy was that? 3 How easy was that? 4 How easy was that? 5 (OK) How easy was that? 6 How easy was that? 7 How easy was that? 8 How easy was that? 9 How easy was that? 10 (Very easy) Question Title * 9. How do your symptoms affect your everyday life and ability to walk? I suffer from symptoms such as pain and numbness, but not imbalance, incontinence (inability to control my bladder) or weakness I suffer imbalance, incontinence (inability to control my bladder) or weakness, but my walking is unaffected. I have a slight difficulty walking, but it does not prevent me from working or completing my daily activities I have moderate difficulty walking, which prevents me from working or completing daily activities. I require assistance to walk I am unable to walk Question Title * 10. How easy was question 9 to complete, on a scale of 1 to 10? 1 (Very difficult) 2 3 4 5 (OK) 6 7 8 9 10 (Very easy) How easy was that? How easy was that? 1 (Very difficult) How easy was that? 2 How easy was that? 3 How easy was that? 4 How easy was that? 5 (OK) How easy was that? 6 How easy was that? 7 How easy was that? 8 How easy was that? 9 How easy was that? 10 (Very easy) Next