The SF-36 in Lyme and Covid

The purpose of this post is to discuss a portion of a questionnaire that has been used to measure the impact of PTLD. For now it is not password protected because we are not making any drug, or any other claims, about CopperOne. If you are any patient suffering from a post infection syndrome, please leave your comments on whether these questions address your concerns.

The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability. To calculate the scores it is necessary to purchase special software for the commercial version, but no special software is needed for the RAND-36 version. Pricing depends on the number of scores that the researcher needs to calculate. In a previous post on PTLD it was noted that Turk and coworkers [1] only used the modules and evidentially declined to use the physical function module of the SF-36 as a measure of fatigue. They did use the physical function and the mental health modules.

Wikipedia author (s) criticize the SF-36 for not having a sleep module.

Physical Functioning [2]

The following questions are about activities you might do during a typical day. Does YOUR HEALTH NOW LIMIT YOU in these activities? If so, how much?

  • PF1 VIGOROUS activities such as running, lifting heavy objects, participating in strenuous sports
  • PF2 MODERATE activities, such as moving a table, pushing a vacuum cleaner, bowling or playing golf
  • PF3 Lifting or carrying groceries
  • PF4 Climbing SEVERAL flights of stairs
  • PF5 Climbing ONE flight of stairs
  • PF6 Bending, kneeling or stooping
  • PF7 Walking MORE THAN ONE kilometre
  • PF8 Walking HALF a kilometre
  • PF9 Walking 100 metres
  • PF10 Bathing or dressing yourself
Code Response
  • 1 Yes, limited a lot
  • 2 Yes, limited a little
  • 3 No, not limited at all

ALSWH re-coding of missing items Sets of related items within the physical functioning sub-scale establish the level of function for particular activities: overall activity level (PF1 to PF3), climbing (PF4 and PF5) and walking (PF7 to PF9). Where a higher level of functioning in each setis ‘Not limited’ but an item for a lower level of the related function is ‘missing’, the lower level of functioning is re-coded to ‘Not limited’. Conversely, where a lower level of functioning is ‘Limited a lot’ and the item for a higher level of the related function is ‘missing’, the higher level of functioning is re-coded to ‘Limited a lot’ blah, blah, blah

Mental Health [2]

For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the PAST 4 WEEKS:

  • MH1 Have you been a very nervous person
  • MH2 Have you felt so down in the dumps that nothing could cheer you up
  • MH3 Have you felt calm and peaceful
  • MH4 Have you felt down
  • MH5 Have you been a happy person

Code Re-code 1 MH3 & MH 5 Response 1 6 All of the time2 5 Most of the time 3 4A good bit of the time 43 Some of the time52 A little of the time 6 1 None of the time [2] blah, blah, blah


  1. Turk, S. P., Lumbard, K., Liepshutz, K., Williams, C., Hu, L., Dardick, K., Wormser, G. P., Norville, J., Scavarda, C., McKenna, D., Follmann, D., & Marques, A. (2019). Post-treatment Lyme disease symptoms score: Developing a new tool for research. PloS one, 14(11), e0225012. PMC free article

Published by BL

I like to write educational websites

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