Date of completion
Tegner Lysholm Knee Scoring Scale
Clinician's name (or ref)
Patient's name (or ref)
Patient's d.o.b
 
This questionnaire has been designed to give your therapist information as to how your knee pain has affected your ability to manage in everyday life.  Please answer every question by placing a mark in the box that best describes your condition today.
During the past 4 weeks......  
1 -Limp   2 -Support
None   None
Slight or periodical   Stick or crutch
Severe and constant   Weight-bearing impossible
     
3 - Pain   4 - Instability
None   Never giving way
Inconstant and slight during severe exertion   Rarely during athletics or other severe exertion
Marked during severe exertion  

Frequently during athletics or other severe exertion (or incapable of participation)

Marked on or after walking more than 2 km   Occasionally in daily activities
Marked on or after walking less than 2 km   Often in daily activities
Constant   Every step

 

  

 
5 -Locking   6 - Swelling
No locking and no catching sensations   None
Catching sensation but no locking   On severe exertion
LockingOccasionally   On ordinary exertion
Frequently   Constant
Locked joint on examination      

 

  

 
7 - Stair-climbing   8 - Squatting
No problems   No problems
Slightly impaired   Slightly impaired
One step at a time   Not beyond 90°
Impossible   Impossible

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Tegner Lysholm Knee Score is

Grading the Tegner Lysholm Knee Scoring Scale

<65
 Poor
65-83
Fair
84-90
Good
>90
Excellent

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Fritz JM, George S. Identifying Psychosocial Variables in Patients With Acute Work-Related Low Back Pain: The Importance of Fear-Avoidance Beliefs. Phys Ther. 2002; 82(10): 973-983.

Lethem J, Slade PD, Troup JDG, Bendey G. Outline of a fear avoidance model of exaggerated pain perceptions, Behav Res Ther. 1983;21:401-408.

Williamson E. Fear Avoidance Behavior Questionnaire. Austrailian Journal of Physiotherapy. 2006; 52: 149.

Vlaeyen JWS, Kole-Snijders AMJ, Boeren RGB, van Eck H. Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain. 1995;62: 36, 272.