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)