Lower Extremity Functional Scale (LEFS)

Original Editor - Emily Hanson

Top Contributors -

Emily Hanson and Naomi O'Reilly  



The objective of the Lower Extremity Functional Scale (LEFS) is to measure "patients' initial function, ongoing progress, and outcome" for a wide range of lower-extremity conditions.[1] [2]

Intended Population

The LEFS is intended for use on adults with lower extremity conditions.[1] [2]

Method of Use

The LEFS is a self-report questionnaire. Patients answer the question "Today, do you or would you have any difficulty at all with:" in regards to twenty different everyday activities.[1] [2] 

Patients select an answer from the following scale for each activity listed:

  1. Extreme Difficulty or Unable to Perform Activity
  2. Quite a Bit of Difficulty
  3. Moderate Difficulty
  4. A Little Bit of Difficulty
  5. No Difficulty

The patient's score is tallied at the bottom of the page. The maximum possible score is 80 points, indicating very high function. The minimum possible score is 0 points, indicating very low function.

Example Questionnaire: Pdf_icon.gif Lower Extremity Functional Scale




Internal reliability for the LEFS is excellent (α=0.96). Test-retest reliability estimates were R=.86 (95% lower limit CI=.80) for the entire sample (n=98) and R=.94 (95% lower limit CI=.89) for the subset of patients with more chronic conditions (n=31).[1]


The LEFS is a valid tool as compared to the SF-36.[1]


The minimum detectable change (MDC) for the LEFS is 9 points. That is, a change of more than 9 points represents a true change in the patient's condition.[1]

The minimum clinically important difference (MCID) for the LEFS is 9 points. That is, "Clinicians can be reasonably confident that a change of greater than 9 points is... a clinically meaningful functional change."[1]

The capacity of the LEFS to detect change in lower-extremity function appears to be superior to that of the SF-36 physical function subscale, as indicated by higher correlations with an external prognostic rating of change.[1]


The LEFS has an error of +/- 5 points. That is, the tabulated score is within 5 points of a patient's "true" score.[1]


Lower Extremity Functional Scale (McReady Foundation)

Lower Extremity Functional Scale (Emory Healthcare)

Recent Related Research (from Pubmed)


  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 Binkley JM, Stratford PW, Lott SA, Riddle DL. The lower extremity functional scale (LEFS): scale development, measurement properties, and clinical application. Phys Ther 1999;79:371-383.
  2. 2.0 2.1 2.2 Rehabilitation Measures Database Lower Extremity Functional Scale http://www.rehabmeasures.org/Lists/RehabMeasures/DispForm.aspx?ID=1113 (accessed 24 Mar 2015).
  3. Fillechaud. Scoring the LEFS. Available from: https://www.youtube.com/watch?v=4CDhRMZCWQ4 [last accessed 24/03/2015]