MOxFQ

Manchester-Oxford Foot Questionnaire (MOxFQ)

First Name

Last Name

Today's date

On which side of your body is the affected joint, for which you are receiving/have received treatment? If both lower limbs are affected, please complete the questionnaire once for each side. (Complete the questionnaire for one side and then return to the link and complete another form for the other side)

LeftRight

Please choose the most applicable option for each question

1. During the past 4 weeks this has applied to me: I have pain in my foot

2. During the past 4 weeks this has applied to me: I avoid walking long distances because of pain in my foot

3. During the past 4 weeks this has applied to me: I change the way I walk due to pain in my foot

4. During the past 4 weeks this has applied to me: I walk slowly because of pain in my foot

6. During the past 4 weeks this has applied to me: I avoid some hard or rough surfaces because of pain in my foot

5. During the past 4 weeks this has applied to me: I have to stop and rest my foot because of pain

7. During the past 4 weeks this has applied to me: I avoid standing for a long time because of pain in my foot

8. During the past 4 weeks this has applied to me: I catch the bus or use the car instead of walking, because of pain in my foot

9. During the past 4 weeks this has applied to me: I feel self-conscious about my foot

10. During the past 4 weeks this has applied to me: I feel self-conscious about the shoes I have to wear

11. During the past 4 weeks this has applied to me: The pain in my foot is more painful in the evening

12. During the past 4 weeks this has applied to me: I get shooting pains in my foot

13. During the past 4 weeks this has applied to me: The pain in my foot prevents me from carrying out my work/everyday activities

14. During the past 4 weeks this has applied to me: I am unable to do all my social or recreational activities because of pain in my foot

15. During the past 4 weeks: How would you describe the pain you usually have in your foot?

16. During the past 4 weeks: Have you been troubled by pain from your foot in bed at night?

Comments

Please check that you have answered every question before clicking Submit