Select the word that best represents your current lifestyle in response to the statement.
|
- I engage in a formal exercise routine.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- I am in the acceptable range for body fat percentage.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- I stand in a stationary position for long periods of time.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- I sit in a stationary position for long periods of time.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- I sit with both feet flat on the floor.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- I sit with my back up against the backrest.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- When I sit, I reach, stretch, and twist to do my work.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- When I drive, I move the seat back as far as possible.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- When I carry something, I carry it as close to the body
as possible.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- When I carry something, I balance it on both sides on
my body.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- When I lift something, Iuse my legs.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- When I lift something, I twist and turn while doing it.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- My job requires me to lift heavy objects.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- My job requires me to lift lighter objects continually.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- I sleep on my stomach.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- I sleep on my back.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- I sleep on a very soft mattress/surface.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- My job requires me to do a lot of pushing.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- My job requires me to do a lot of pulling.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- I am conscious of my posture.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- I eat a balanced mixed diet.
|
Always:
Regularly:
Sometimes:
Rarely:
Never:
|
- My age is
|
20 - 29:
30 -39:
40 - 49:
50 - 59:
60 - 69:
|
