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Protocol - Long COVID - Physical Functioning

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Description

A self-administered questionnaire that asks about the effects of Long COVID symptoms on physical functioning.

Specific Instructions

None

Availability

Available

Protocol

1. Before COVID-19, were you limited in any way in any activities because of physical, mental, or emotional problems?

[ ] Yes (specify)

[ ] No

[ ] Refuse to answer

 1a. Please specify how you were limited before COVID-19: ___________

2. Before COVID-19, did you have any health problem that required you to use special equipment, such as a cane, a wheelchair, a special bed, or a special telephone?

*Include occasional use or use in certain circumstances

[ ] Yes

[ ] No

[ ] Refuse to answer

3. Do you have any difficulty walking a quarter of a mile, that is about 2 or 3 blocks, without stopping?

[ ] Yes

[ ] No

[ ] Refuse to answer

4. How much difficulty do you have walking a quarter of a mile?

[ ] A little

[ ] Some

[ ] A lot

[ ] Unable to do

[ ] Refuse to answer

5. Did you have difficulty walking a quarter of a mile before your COVID-19 illness?

[ ] Yes

[ ] No

[ ] Refuse to answer

6. How easy is it for you to walk a quarter of a mile?

[ ] Very easy

[ ] Somewhat easy

[ ] Not so easy

[ ] Refuse to answer

7. Do you have any difficulty walking a distance of one mile?

[ ] Yes

[ ] No

[ ] Refuse to answer

8. Did you have difficulty walking one mile before your COVID-19 illness?

[ ] Yes

[ ] No

[ ] Refuse to answer

9. How easy is it for you to walk one mile?

[ ] Very easy

[ ] Somewhat easy

[ ] Not so easy

[ ] Refuse to answer

10. Do you have any difficulty walking up 10 steps, that is about 1 flight, without resting?

[ ] Yes

[ ] No

[ ] Refuse to answer

11. How much difficulty do you have walking up 10 steps?

[ ] A little

[ ] Some

[ ] A lot

[ ] Unable to do

[ ] Refuse to answer

12. Did you have difficulty walking up 10 steps before your COVID-19 illness?

[ ] Yes

[ ] No

[ ] Refuse to answer

13. How easy is it for you to walk up 10 steps?

[ ] Very easy

[ ] Somewhat easy

[ ] Not so easy

[ ] Refuse to answer

14. Do you have any difficulty walking up 20 steps, that is about 2 flights, without resting?

[ ] Yes

[ ] No

[ ] Refuse to answer

15. Did you have difficulty walking up 20 steps before your COVID-19 illness?

[ ] Yes

[ ] No

[ ] Refuse to answer

16. How easy is it for you to walk up 20 steps?

[ ] Very easy

[ ] Somewhat easy

[ ] Not so easy

[ ] Refuse to answer

17. Do you have difficulty doing light housework such as doing dishes, straightening up or light cleaning by yourself?

[ ] Yes

[ ] No

[ ] Refuse to answer

18. How much difficulty do you have doing light housework?

[ ] A little

[ ] Some

[ ] A lot

[ ] Unable to do

[ ] Refuse to answer

19. Did you have difficulty doing light housework before your COVID-19 illness?

[ ] Yes

[ ] No

[ ] Refuse to answer

20. Do you have difficulty doing heavy housework such as vacuuming and washing windows, walls, or floors?

[ ] Yes

[ ] No

[ ] Refuse to answer

21. How much difficulty do you have doing heavy housework?

[ ] A little

[ ] Some

[ ] A lot

[ ] Unable to do

[ ] Refuse to answer

22. Did you have difficulty doing heavy housework before your COVID-19 illness?

[ ] Yes

[ ] No

[ ] Refuse to answer

23. Prior to your initial COVID-19 illness, during a typical 7-day period (a week), how many times on average did you do the following kinds of exercise for more than 15 minutes during your free time?

 23a. Strenuous exercise (heart beats rapidly)?

 __________times per week

 Examples: running, jogging, hockey, football, soccer, squash, basketball,

 cross country skiing, judo, roller skating, vigorous swimming, vigorous long

 distance bicycling

 23b. Moderate exercise (not exhausting)?

 __________times per week

 Examples: fast walking, baseball, tennis, easy bicycling, volleyball,

 badminton, easy swimming, alpine skiing, popular and folk dancing

 23c. Mild/light exercise (minimal effort)?

 __________times per week

 Examples: yoga, archery, fishing from river bank, bowling, horseshoes, golf,

 snow-mobiling, easy walking

24. Since your initial COVID-19 illness, during a typical 7-day period (a week), how many times on average do you do the following kinds of exercise for more than 15 minutes during your free time?

 24a. Strenuous exercise (heart beats rapidly)?

 __________times per week

 Examples: running, jogging, hockey, football, soccer, squash, basketball,

 cross country skiing, judo, roller skating, vigorous swimming, vigorous long

 distance bicycling

 24b. Moderate exercise (not exhausting)?

 __________times per week

 Examples: fast walking, baseball, tennis, easy bicycling, volleyball,

 badminton, easy swimming, alpine skiing, popular and folk dancing

 24c. Mild/light exercise (minimal effort)?

 __________times per week

 Examples: yoga, archery, fishing from river bank, bowling, horseshoes, golf,

 snow-mobiling, easy walking


Personnel and Training Required

None

Equipment Needs

None

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Self-administered questionnaire

Lifestage

Adult, Senior

Participants

Adults aged 18 years or older

Selection Rationale

PhenX used input from the PhenX Steering Committee to enable rapid response and release of COVID-19 related protocols in the Toolkit.

Language

English, Other languages available at source

Standards
StandardNameIDSource
Derived Variables

None

Process and Review

Not applicable

Protocol Name from Source

Johns Hopkins COVID Long Study

Source

Johns Hopkins University, Johns Hopkins COVID Long Study, January 2022, Limitations & Exercise Form

General References
None
Protocol ID

992201

Variables
Export Variables
Variable Name Variable IDVariable DescriptiondbGaP Mapping
PX992201_Long_Covid_Physical_Function_After_Light_Exercise_Times_Per_Week
PX992201250300 Since your initial COVID-19 illness, during more
a typical 7-day period (a week), how many times on average do you do the following kinds of exercise for more than 15 minutes during your free time? Mild/light exercise (minimal effort)? show less
N/A
PX992201_Long_Covid_Physical_Function_After_Moderate_Exercise_Times_Per_Week
PX992201250200 Since your initial COVID-19 illness, during more
a typical 7-day period (a week), how many times on average do you do the following kinds of exercise for more than 15 minutes during your free time? Moderate exercise (not exhausting)? show less
N/A
PX992201_Long_Covid_Physical_Function_After_Strenuous_Exercise_Times_Per_Week
PX992201250100 Since your initial COVID-19 illness, during more
a typical 7-day period (a week), how many times on average do you do the following kinds of exercise for more than 15 minutes during your free time? Strenuous exercise (heart beats rapidly)? show less
N/A
PX992201_Long_Covid_Physical_Function_Before_Difficulty_Walk_Heavy_Housework_Any
PX992201230000 Did you have difficulty doing heavy more
housework before your COVID-19 illness? show less
N/A
PX992201_Long_Covid_Physical_Function_Before_Difficulty_Walk_Light_Housework_Any
PX992201200000 Did you have difficulty doing light more
housework before your COVID-19 illness? show less
N/A
PX992201_Long_Covid_Physical_Function_Before_Difficulty_Walk_One_Mile_How_Much
PX992201090000 Did you have difficulty walking one mile more
before your COVID-19 illness? show less
N/A
PX992201_Long_Covid_Physical_Function_Before_Difficulty_Walk_Quarter_Mile_Any
PX992201060000 Did you have difficulty walking a quarter of more
a mile before your COVID-19 illness? show less
N/A
PX992201_Long_Covid_Physical_Function_Before_Difficulty_Walk_Ten_Steps_Any
PX992201130000 Did you have difficulty walking up 10 steps more
before your COVID-19 illness? show less
N/A
PX992201_Long_Covid_Physical_Function_Before_Difficulty_Walk_Twenty_Steps_Any
PX992201160000 Did you have difficulty walking up 20 steps more
before your COVID-19 illness? show less
N/A
PX992201_Long_Covid_Physical_Function_Before_Health_Problem_Special_Equipment
PX992201030000 Before COVID-19, did you have any health more
problem that required you to use special equipment, such as a cane, a wheelchair, a special bed, or a special telephone? *Include occasional use or use in certain circumstances show less
N/A
PX992201_Long_Covid_Physical_Function_Before_Light_Exercise_Times_Per_Week
PX992201240300 Prior to your initial COVID-19 illness, more
during a typical 7-day period (a week), how many times on average did you do the following kinds of exercise for more than 15 minutes during your free time? Mild/light exercise (minimal effort)? show less
N/A
PX992201_Long_Covid_Physical_Function_Before_Limit_Activity_Physical_Mental_Emotional_Problem
PX992201010000 Before COVID-19, were you limited in any way more
in any activities because of physical, mental, or emotional problems? show less
N/A
PX992201_Long_Covid_Physical_Function_Before_Limit_Activity_Physical_Mental_Emotional_Problem_Specify
PX992201020000 Please specify how you were limited before more
COVID-19 show less
N/A
PX992201_Long_Covid_Physical_Function_Before_Moderate_Exercise_Times_Per_Week
PX992201240200 Prior to your initial COVID-19 illness, more
during a typical 7-day period (a week), how many times on average did you do the following kinds of exercise for more than 15 minutes during your free time? Moderate exercise (not exhausting)? show less
N/A
PX992201_Long_Covid_Physical_Function_Before_Strenuous_Exercise_Times_Per_Week
PX992201240100 Prior to your initial COVID-19 illness, more
during a typical 7-day period (a week), how many times on average did you do the following kinds of exercise for more than 15 minutes during your free time? Strenuous exercise (heart beats rapidly)? show less
N/A
PX992201_Long_Covid_Physical_Function_Today_Difficulty_Walk_Heavy_Housework_Any
PX992201210000 Do you have difficulty doing heavy housework more
such as vacuuming and washing windows, walls, or floors? show less
N/A
PX992201_Long_Covid_Physical_Function_Today_Difficulty_Walk_Heavy_Housework_How_Much
PX992201220000 How much difficulty do you have doing heavy more
housework? show less
N/A
PX992201_Long_Covid_Physical_Function_Today_Difficulty_Walk_Light_Housework_Any
PX992201180000 Do you have difficulty doing light housework more
such as doing dishes, straightening up or light cleaning by yourself? show less
N/A
PX992201_Long_Covid_Physical_Function_Today_Difficulty_Walk_Light_Housework_How_Much
PX992201190000 How much difficulty do you have doing light more
housework? show less
N/A
PX992201_Long_Covid_Physical_Function_Today_Difficulty_Walk_One_Mile_Any
PX992201080000 Do you have any difficulty walking a more
distance of one mile? show less
N/A
PX992201_Long_Covid_Physical_Function_Today_Difficulty_Walk_Quarter_Mile_Any
PX992201040000 Do you have any difficulty walking a quarter more
of a mile, that is about 2 or 3 blocks, without stopping? show less
N/A
PX992201_Long_Covid_Physical_Function_Today_Difficulty_Walk_Quarter_Mile_How_Much
PX992201050000 How much difficulty do you have walking a more
quarter of a mile? show less
N/A
PX992201_Long_Covid_Physical_Function_Today_Difficulty_Walk_Ten_Steps_Any
PX992201110000 Do you have any difficulty walking up 10 more
steps, that is about 1 flight, without resting? show less
N/A
PX992201_Long_Covid_Physical_Function_Today_Difficulty_Walk_Ten_Steps_How_Much
PX992201120000 How much difficulty do you have walking up more
10 steps? show less
N/A
PX992201_Long_Covid_Physical_Function_Today_Difficulty_Walk_Twenty_Steps_Any
PX992201150000 Do you have any difficulty walking up 20 more
steps, that is about 2 flights, without resting? show less
N/A
PX992201_Long_Covid_Physical_Function_Today_Ease_Walk_One_Mile
PX992201100000 How easy is it for you to walk one mile? N/A
PX992201_Long_Covid_Physical_Function_Today_Ease_Walk_Quarter_Mile
PX992201070000 How easy is it for you to walk a quarter of more
a mile? show less
N/A
PX992201_Long_Covid_Physical_Function_Today_Ease_Walk_Ten_Steps
PX992201140000 How easy is it for you to walk up 10 steps? N/A
PX992201_Long_Covid_Physical_Function_Today_Ease_Walk_Twenty_Steps
PX992201170000 How easy is it for you to walk up 20 steps? N/A
Long COVID
Measure Name

Long COVID - Physical Functioning

Release Date

March 17, 2023

Definition

This protocol assesses how long COVID symptoms affects physical functioning.

Purpose

Presence of lingering COVID-19 symptoms is a sign of Long COVID, and use of this measure helps with understanding people’s experience with COVID-19 and implications of Long COVID.

Keywords

coronavirus, Johns Hopkins, COVID, long COVID, physical functioning

Measure Protocols
Protocol ID Protocol Name
992201 Long COVID - Physical Functioning
Publications

There are no publications listed for this protocol.