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Development of Surface Roughness Standards for Pathways Used by Wheelchair Users: Final Report

APPENDIX C

SUBJECTIVE RATING QUESTIONNAIRE

Acceptable? yes no undecided; rating: very good, good, fair, poor, very poor

2. What was your pain/discomfort value associated with this surface (circle)?
0    1      2      3      4      5     6    7     8    9     10
None                                                     Extreme

3. What surface does this trial most feel like (put a mark in the most appropriate box)?

  New Worn Broken/warped
Concrete      
Brick      
Cobblestone      
Wood Deck       
Other:_________      

4. How would this surface hinder your decision to travel 5 blocks (5 football fields, 0.45km, 0.25mi) to get to a leisure activity?

Greatly      Slightly     Not at all

 

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