Multiple Sclerosis Activity Assessment

Do you have difficulty walking short distances?

Do you need support (cane/person) while walking?

Have you recently lost balance or experienced falls?

Do you experience blurred or double vision?

Have you previously experienced partial vision loss in one eye?

Do you feel weakness in your arms or legs?

Do you experience numbness or tingling?

Do you have difficulty gripping objects?

Do you have difficulty with concentration or memory?

Do you have difficulty speaking or swallowing food?

Do you feel severe fatigue affecting your daily life?

Do you suffer from chronic pain?

Do you have problems controlling urination?

Have new symptoms appeared within the last 6 months?

Have your old symptoms worsened significantly?

Can you walk more than 500 meters without resting?

Do you need a cane or mobility aid for walking?

Do you rely on a wheelchair or daily assistance?