Stay Independent - 60 Day Results
Record your results in the form below.
Please enter the Program (SI) and the test period, (60 Days) below.
Age
50-59
60-69
70-79
90+
Sex
Female
Male
1. Sit-to-Stand
1 - less than 7
2 - 7-13
3 - 14 or more
2 Single-Leg-Stand
1. Less than 5 seconds
2. 5-9 seconds
3 More than 10 seconds
3 Push-Ups
1. Less than 7
2. 7-14
3. More than 15
4 Grip- Strength
1 Weak squeeze
2. Moderate squeeze
3 Strong, steady squeeze
5 Down-to-Floor-and-Up
1 Unable or unsafe to try
2 Use of chair
3 Down and up easily
6 Walking Endurance
1. Stopped due to symptoms
2. Slow and needs rest
3. Brisk pace for 5 minutes
Submit
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