LEFS Calculator
Score the Lower Extremity Functional Scale below, free, no account. In a real chart, the same block scores it automatically at every visit and charts the trend for you.
Lower Extremity Functional Scale
What the LEFS measures
The Lower Extremity Functional Scale (LEFS) is a 20-item patient-reported questionnaire for function in people with a hip, knee, ankle or foot problem. It was published by Binkley and colleagues in 1999 and is one of the most widely used lower-limb measures in physiotherapy because it works across diagnoses rather than for one joint.
Unlike most disability indexes, a higher LEFS score is better: 80 means no difficulty with any of the listed activities.
How to score the LEFS
- The patient rates each of the 20 activities from 0 (extreme difficulty or unable to perform) to 4 (no difficulty).
- Add the 20 item scores. The total runs from 0 to 80.
- To express it as a percentage of full function, divide the total by 80 and multiply by 100. A score of 60 is 75% of maximal function.
Score the questionnaire the way it is written: the patient answers about their difficulty today, not what they could do before the injury.
Interpreting the score
The LEFS has no official severity bands. The total is read as a level of function and, more usefully, compared with the patient's own earlier scores.
| LEFS total | What it reflects |
|---|---|
| 80 | No reported difficulty with any listed activity |
| 60 (75%) | Some difficulty, usually with higher-demand items such as running, hopping or squatting |
| 40 (50%) | Substantial limitation in everyday activities |
| 20 or less | Severe limitation; most activities difficult or impossible |
The descriptions are illustrative, to help explain a score to a patient. They are not validated cut-offs.
What counts as a meaningful change
In the original validation study, the minimal detectable change (90% confidence) and the minimal clinically important difference were both 9 points. A change of 9 or more between two assessments is larger than measurement error and is likely to matter to the patient.
A 5-point improvement may be real, but you cannot distinguish it from day-to-day variation on one re-test. Look for the trend across several visits.
Using the LEFS in your clinic
Most clinics give the LEFS at intake, at re-assessment and at discharge, and use the change to support progress reports for insurers and referring physicians. In Zdrovia, the score is saved to the chart at each visit and graphed automatically. See how that works for physiotherapy clinics.
Frequently asked questions
What is a good LEFS score?
Higher is better, with 80 as the maximum. There is no official cut-off for a 'good' score; what matters clinically is change over time. An improvement of 9 points or more is considered clinically meaningful.
What is the MCID for the LEFS?
Nine points. Binkley et al. (1999) reported both the minimal detectable change and the minimal clinically important difference as 9 scale points.
How do you convert a LEFS score to a percentage?
Divide the total by 80 and multiply by 100. For example, 52 ÷ 80 × 100 = 65% of maximal function.
Is a higher LEFS score better or worse?
Better. Each item is scored 0 (unable) to 4 (no difficulty), so a higher total means less difficulty. This is the opposite direction to the Oswestry and Neck Disability indexes.
Is the LEFS free to use?
The LEFS is widely reproduced for clinical use without a licence fee. Check your organisation's policy if you plan to publish it or build it into commercial software.
Sources
This page is a reference for clinicians, not medical advice. Scoring conventions and change thresholds vary between studies; follow your profession's guidance and the instrument's official user manual.
Score once. Trend forever.
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Score it in the visit
The patient answers, or you do it with them. The total and interpretation compute live, the same way PHQ-9 and GAD-7 already do in Zdrovia today.
Watch it trend
Every score across every visit lands on one chart automatically, no spreadsheet, no re-typing old scores to see if the patient is improving.
The score you enter is the graph you get
Because a scored questionnaire is a structured field and not a paragraph in a note, every visit's total lands on the same trend line the moment it's saved, the same mechanism already charting PHQ-9 and GAD-7 in the live product.
- Reference lines for clinically meaningful change, not just raw movement
- Compare against intake automatically, no manual lookup
- Exportable for a referral or an insurer's progress report
- Works the same for any scale your clinic defines
One scoring engine, any instrument
Any validated instrument
LEFS is the pilot. The same scoring engine already runs PHQ-9 and GAD-7 in the live product: NDI, DASH, ODI, KOOS, and HOOS are the same shape of problem: fixed items, a running total, a band or threshold.
Item-level flags, not just a total
A single alarming answer (a suicidality item on PHQ-9, a red-flag item on a spinal screen) can surface immediately instead of getting averaged away into the total score.
Trend graphs for free
Because the score is a structured field and not a paragraph of prose, it's chartable the moment it's saved. No separate outcomes-tracking spreadsheet to keep in sync with the chart.
Build the ones you need
Don't wait on us to ship your specialty's instrument. Custom Smart Blocks let your clinic define its own scored scale with the same item-and-band structure.
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