PFIT RECORDING SHEET (beats per 1. Heart Rate Pre:_________ Post:__________ minute) 2. SpO2 (%) Pre:_________ Post:__________ 3. Sit stand assistance – (circle) 0 1 2 unable Chair/bed height (distance __________________ to floor, cm) Chair arms used? Yes No 4. MOS _________________ 4.1 RPE (pre) 4.2 Able? (circle) Yes No 4.3 Steps (no.) ________________ 4.4 Time (sec) ________________ 4.5 RPE (post) ________________ 5. Strength Left Right 5.1 Shoulder Flexion ___________ ___________ 5.2 Knee Extension ___________ ___________
PFIT RECORDING SHEET 1. Heart Rate (beats per minute) Pre:_________ Post:__________ 2. SpO2 (%) Pre:_________ Post:__________ 3. Sit – stand assistance (circle) Chair/bed height (distance to floor, cm) Chair arms used? 0 1 2 unable __________________ Yes No 4. MOS 4.1 RPE (pre) _________________ 4.2 Able? (circle) Yes No 4.3 Steps (no.) ________________ 4.4 Time (sec) ________________ 4.5 RPE (post) ________________ 5. Strength Left Right 5.1 Shoulder Flexion 5.2 Knee Extension ___________ ___________ ___________ ___________
PFIT-instructions-2013.docx