LYSHOLM KNEE SCORING SCALE

LYSHOLM KNEE SCORING SCALE

LYSHOLM KNEE SCORING SCALE
Full Name/Participant’s Name:

First NameLast Name
Email
example@example.com
Instructions: Below are common complaints which people frequently have with their knee problems. Please check the statement which best describes your condition.
Limp
Using cane or crutches
Locking sensation in the knee
Giving way sensation from the knee
Pain

Swelling
Climbing Stairs
Squatting
Right knee
Left knee
Calculation
Date

MonthDayYear
Date
Parent/guardian signature:

Please affix your signature inside the box

p. 443.979.7171

AAA Physical Therapy, LLC
admin@AAAPhysicalTherapy.com
8975 Guilford Rd Ste 170 Columbia, MD 21046

f. 667.200.5908

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