Lower Extremity Functional Scale

What is a Lower Extremity Functional Scale (LEFS)?

The Lower Extremity Functional Scale (LEFS) or lower extremity functional index is an outcome measure used by physical/occupational therapists and rehabilitation specialists to assess the functional status of individuals with lower extremity impairments. This tool helps evaluate the physical function and disability related to lower extremity impairments and includes walking, stair climbing, balance, and standing.

The Lower Extremity Functional Scale helps quantify the level of difficulty that individuals experience while performing activities. The score ranges from 0 (unable to perform activity) to 80 (no difficulty in performing activity).

Because of its measurement properties and scale development, which involved a systematic process of item selection that ensured its reliability and validity in clinical settings, the LEFS is used as a clinical and research tool to measure an individual’s progress over time in clinical settings and research studies.

How to use this Lower Extremity Functional Scale template?

This LEFS worksheet contains 20 questions to help you measure your patient's lower extremity functionality. Follow these steps to begin:

Step 1: Download the assessment

Click on the link provided to download a copy of the LEFS assessment. Once you download it, you can print it out or save a digital copy for your patient.

Step 2: Give your patient a copy

Give your patient a copy of the LEFS and explain how it works. Tell them each question is scored on a scale from 0 to 4, with 0 representing extreme difficulty, 2 representing moderate difficulty, and 4 being no difficulty when performing the activity.

Step 3: Have your patient complete the assessment

Give your patient the time and space to complete the LEFS independently. Encourage them to answer each question honestly and accurately.

Step 4: Calculate the score

Once your patient has completed the assessment, proceed to the Lower Extremity Functional Scale scoring. Calculate their total LEFS score by adding all the numbers. Scores range from 0 to 80, with 0 representing no difficulty and the maximum score of 80 representing total inability to perform the activity.

It's important to note that when scoring, the minimal clinically important difference (MCID) for the LEFS is 9 points, representing a clinically meaningful functional change. This means that a change of 9 points can indicate either an improvement or deterioration in lower extremity function. Understanding the MCID is crucial in clinical practice, as it helps clinicians determine whether changes in a patient’s condition are due to actual improvements or declines in their functional status rather than other factors.

Step 5: Store the worksheet properly

Store the worksheet properly so you can refer to it if needed. You may also want to note your patient's LEFS score in their medical chart.

When would you typically use the Lower Extremity Functional Scale?

The LEFS is typically used to measure the functional status of individuals with lower extremity impairments and track their progress over time. It can also be used to:

Measure the functional status of individuals with lower extremity impairments

This scale measures how well your patient with lower extremity musculoskeletal dysfunction can do activities related to their lower body, like walking and standing. It can help you understand how much difficulty your patient has with each activity.

Track progress over time

You can use the Lower Extremity Functional Scale to assess and document the patients' initial function, monitor the effectiveness of physical therapy interventions, and track progress over time. This allows you to understand better how your patients respond to the treatments they are receiving.

Assess individuals' level of difficulty

The LEFS can provide valuable insight into individuals’ difficulties with specific activities. It includes evaluating challenges such as putting on shoes or socks and running on uneven ground, which is crucial for assessing functional limitations in patients with musculoskeletal conditions. This can help you examine how your patient functions in daily life and tailor the most beneficial interventions.

Benefits of using the Free Lower Extremity Functional Scale

LEFS offers a wide range of benefits for healthcare professionals, including:

Reliable and accurate

The LEFS is a tool doctors and physical therapists use to measure how well someone can do activities related to their lower body. It can be used repeatedly in observing how the lower extremity function appears, ensuring reliable and valid measurements each time. The LEFS accurately measures the functional status of individuals with lower extremity impairments.

Responsive to change

The test appears responsive to change, meaning it can detect small and significant changes in your patient’s functional status over time. This makes it an ideal tool for tracking progress and evaluating the effectiveness of treatments.

Easy to use

The LEFS is simple and easy to use, making it a convenient option for busy healthcare professionals. It only takes a few minutes to complete and provides valuable insight into the functional status of patients with lower extremity impairments.

Provide insight into an individual's difficulty level

The LEFS can provide valuable insight into individuals' difficulties with specific activities. This can help you better understand how your patient navigates their daily life and create the best interventions for their needs.

It can be used in a variety of clinical settings

The Lower Extremity Functional Scale is a handy assessment tool that enables medical practitioners to measure the functional status of individuals with lower extremity impairments. It can be used in clinical settings like sports physical therapy, physical therapy, occupational therapy, rehabilitation, and regular physician visits.

Help tailor interventions that are most beneficial for individuals

You can use LEFS to monitor the effectiveness of your interventions, giving a more comprehensive look at how your patient responds to the treatments they are receiving.

Completely digital

This LEFS worksheet is optimized for digital use—you don't need to print out or carry around paper copies. If your patient cannot attend their in-person session, you can provide a digital copy and ask them to answer the worksheet.