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Date of completion
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Modified Cincinnati Rating System Questionnaire |
Clinician's name (or ref)
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Patient's name (or ref)
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This questionnaire has been designed to give your therapist information as to how your knee pain has affected your ability to manage in everyday life. Please answer every question by placing a mark in the box that best describes your condition today. |
During the past 4 weeks...... |
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Section 1 - Pain Intensity |
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Section 2 -Swelling |
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No pain, normal knee, performs 100% |
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No swelling |
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Occasional pain with strenuous sports or heavy work, knee not entirely normal, some limitations but minor and tolerable |
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Occasional swelling with strenuous sports or heavy work. Some limitations but minor and tolerable |
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Occasional pain with light recreational sports or moderate work activities, running or, heavy labour, strenuous sports |
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Occasional swelling with light recreational sports or moderate work ativities. Frequently brought on by vigorous activities, running, heavy labour, and strenuous sport |
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Pain, usually brought on by sports, light recreational activities or moderate work. Occasionally occurs with walking, standing or light work |
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Swelling limits sports and moderate work. Occurs infrequently with simple walking activities or light work (approx 3 times a year) |
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Pain is a significant problem with simple activity such as walking, relieved by rest, unable to do sports |
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Swelling brought on by simple walking activities and light work. Relieved by rest |
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Pain present all the time. Not relieved by rest |
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Severe problem all the time, with simple walking activities |
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Section 3 - Giving Way |
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Section 4 - Overall activity level |
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No giving way |
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No limitation, normal knee, able to do everything including strenuous sports or heavy labour |
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Occasional giving way with strenuous sports or heavy work. Can participate in all sports but some guarding or limitations present |
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Perform sports including vigorous activities but at lower performance level: involves guarding or some limits to heavy labour |
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Occasional giving way with light sports or moderate work. Able to compensate but limits vigorous activities, sports, or heavy work not able to cut or twist suddenly. are conveniently positioned (e.g., on a table) |
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Light recreational activities possible with rare symptoms, more strenuous activities cause problems.Active but in different sports; limited to moderate work |
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Giving way limits sports and moderate work, occurs infrequently with walking or light work (approx 3 times per year) |
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No sports or recreational activities possible. Walking with rare symptoms; limited to light work |
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Giving way with simple walking activities and light work. Occurs once per month, requires guarding |
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Walking, ADL cause moderate symptoms, frequent limitations |
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Severe problem with simple walking activities, cannot turn or twist while walking without giving way |
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Walking, ADL cause severe problems, persistent symptoms |
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To save this data please print or |
The Modified Cincinnati Rating System is
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Grading the Modified Cincinnati Rating System Questionnaire |
<30 |
Poor |
30-54 |
Fair |
55-79 |
Good |
>80 |
Excellent |
Reference for Score: Noyes FR, Barber SD, Mooar LA. A rationale for assessing sports activity levels and limitations in knee disorders.
Clin Orthop Relat Res. 1989 Sep;(246):238-49. link to pubmed
Reference for Grading: Bentley G, Biant LC, Carrington RW, Akmal M, Goldberg A, Williams AM, Skinner JA, Pringle J. A prospective, randomised comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects in the knee.
J Bone Joint Surg Br. 2003 Mar;85(2):223-30.
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