Hip Outcome Measurements: Lower Extremity Functional Scale

outcome measures Jun 23, 2023
Lower Extremity Functional Scale

The Lower Extremity Functional Scale (LEFS) is a self-reported outcome measure used to assess the functional status of a patient's lower limb. It is a widely used tool to evaluate the extent to which lower limb pain or disability is affecting a patient's activities of daily living. The LEFS questionnaire consists of 20 items that evaluate a patient's ability to perform basic functional activities, such as walking, climbing stairs, and getting in and out of a chair. Each item is scored on a scale of 0 to 4, with a higher score indicating better function. The total score ranges from 0 to 80, with higher scores indicating better lower limb function.

The LEFS can be used in a variety of settings, including physical therapy, sports medicine, and orthopedic surgery. It is commonly used to assess the effectiveness of interventions, such as physical therapy, rehabilitation, or surgery, in improving lower limb function. The LEFS is appropriate for use in patients with lower limb injuries or disabilities, such as those with hip or knee osteoarthritis, ankle sprains, fractures, or ligament injuries. It is also used in patients who have undergone lower limb surgeries, such as total hip or knee replacement or ligament reconstruction.

The Lower Extremity Functional Scale (LEFS) is scored on a scale of 0 to 80, with higher scores indicating better lower limb function. The interpretation of the scores can be based on the following categories:

  • 0-20: Severe functional limitation
  • 21-40: Moderate functional limitation
  • 41-60: Mild to moderate functional limitation
  • 61-80: Minimal functional limitation or normal function

Normal scores for the LEFS may vary depending on the patient population and the specific lower limb condition being assessed. However, scores in the range of 61-80 are generally considered normal or indicative of minimal functional limitation. Scores in the range of 41-60 may indicate mild to moderate functional limitation, while scores in the range of 20-40 may indicate moderate to severe functional limitation. Scores of 0-20 indicate severe functional limitation.



  1. Binkley JM, Stratford PW, Lott SA, Riddle DL. The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. North American Journal of Sports Physical Therapy : NAJSPT. 1999;1(2):62-72.
  2. Salaffi F, Stancati A, Silvestri CA, Ciapetti A, Grassi W. Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale. European Journal of Pain (London, England). 2004;8(4):283-291.
  3. Gabel CP. The Lower Extremity Functional Scale (LEFS): evidence of factorial validity, responsiveness, and reliability. Journal of Orthopaedic & Sports Physical Therapy. 2014;44(11):798-807.

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