• VISA-Patellar Tendon

    The Victorian Institute of Sport Assessment (VISA-) Patella (P) Questionnaire is a self-report clinical outcome measure used in patients with Patellar Tendinopathy. It consists of eight questions that measure the domains of pain, function in daily living, and sports activities
  • Today's Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • If you are completing this form regarding a different date, enter it here (Month, Day, Year)
     - -
    2 digit month, 2 digit day, 4 digit year
  • Please indicate which knee this survey is about:*
  • VAS: Overall, how bad is your pain (0=no pain, 100 =maximum imaginable pain)*
  • 1. How many minutes can you sit pain free?*
    Rows
  • 2. Do you have pain walking downstairs with a normal gait cycle? *
    Rows
  • 3. Do you have pain at the knee with full active nonweightbearing knee extension?*
    Rows
  • 4. Do you have pain when doing a full weight bearing lunge?*
    Rows
  • 5. Do you have any problems squatting?*
    Rows
  • 6. Do you have pain during or immediately after doing 10 single leg hops?*
    Rows
  • 7. Are you currently involved in any sport or other physical activity?

  • Please complete only one of the folowing: 8A, 8B, or 8C

  • Please select only one of the following:*
  • 8A: If you have NO PAIN while doing sports, how long can you train or practice?
  • 8B: If you have SOME PAIN while doing sports, but it does not stop you from participating, how long can you train or practice?
  • 8C: If you have PAIN WHICH STOPS YOU while doing sports, for how long can you train or practice?

  • Office use only:

    8A: 0, 7, 14, 21, 30
    8B: 0, 4, 10, 14, 20
    8C: 0, 2,  5,  7,  10

     

  • Should be Empty: