For each item, please check the box next to the statement that best reflects your current situation. 70.Moving around moderate distances (10 to 100 meters) I use a wheelchair. To move around, ... ... I need total assistance ... I need an electric wheelchair or partial assistance to operate a manual wheelchair ... I am independent in a manual wheelchair I walk moderate distances and ... ... I need supervision while walking (with or without walking aids) ... I walk with a walking frame or crutches, swinging forward with both feet at a time ... I walk with crutches or two canes, setting one foot before the other ... I walk with one cane ... I walk with a leg orthosis(es) only e.g., leg splint ... I walk without walking aids 70/126
