Arthritis Impact Measurement Scales (AIMS2)

Abstract

The Arthritis Impact Measurement Scale (AIMS2) is a comprehensive, self-administered health status questionnaire designed to measure the impact of arthritis across various physical, psychological, and social domains. Developed as a revision and expansion of the original AIMS, AIMS2 provides a detailed profile of functional status and well-being in patients with rheumatic diseases, such as Rheumatoid Arthritis and Osteoarthritis. The instrument includes 67 items organized into 12 distinct scales, plus additional questions covering patient satisfaction, perceived impact of arthritis, and demographic information. A shorter, validated version, the AIMS2 Short Form (AIMS2-SF), consisting of 26 items, is also widely used for clinical settings and large-scale research where efficiency is paramount.

Keywords

Arthritis Impact Measurement Scale, AIMS2, AIMS2-SF, Health Status, Rheumatology, Quality of Life, Functional Status, Chronic Illness, Rheumatoid Arthritis, Osteoarthritis, Patient Reported Outcomes (PROs)

Authors

Robert F. Meenan, Peter M. Gertman, J.H. Mason, J.J. Anderson, et al. (AIMS original, 1980; AIMS2 revision, 1992)

Purpose

The primary purpose of the AIMS2 is to quantify the multidimensional consequences of arthritis on an individual’s life. It serves as a crucial tool for assessing health outcomes in clinical trials, tracking disease progression over time, and evaluating the effectiveness of medical or rehabilitative interventions.

By covering domains beyond physical function—including pain, mood, and social interaction—AIMS2 allows clinicians and researchers to gain a holistic perspective on the patient’s health status and quality of life, thereby guiding more targeted treatment planning.

Construct

The AIMS2 measures the construct of health status or health-related quality of life specifically as it is impacted by arthritis. This construct is recognized as being multidimensional, encompassing both objective limitations and subjective psychological experiences.

The scale is structured around 12 core domains, reflecting the complexity of living with a chronic, debilitating condition. These domains categorize the impact into areas of physical function (mobility, dexterity, self-care), symptomatic experience (pain, stiffness), and psychosocial well-being (mood, tension, social activity, support).

Validity

The validity of the AIMS2 and AIMS2-SF has been extensively documented in rheumatology literature since the initial publication of AIMS in 1980 and the subsequent revision in 1992. The scale demonstrates strong content validity, as its items were derived from patient interviews and expert review to ensure comprehensive coverage of arthritis impact areas.

Studies have confirmed its construct validity, showing that the domains correlate logically with other established measures of physical function, pain severity, and psychological distress. For instance, the short form (AIMS2-SF) has demonstrated validity among patients with osteoarthritis, confirming its ability to measure relevant changes in functional status and symptoms (Ren, Kazis, Meenan, 1999).

Reliability

The AIMS2 exhibits satisfactory psychometric properties, including high internal consistency and reliability across its various subscales. The revised AIMS2 demonstrated improved internal consistency compared to the original AIMS, with most subscales achieving Cronbach’s alpha values above 0.70, indicating that items within each domain measure a common underlying concept.

Test-retest reliability has been established across different studies, confirming the stability of the measure when administered to patients whose clinical condition remains stable over short periods. The AIMS2-SF maintains comparable reliability to the full version while significantly reducing administrative burden.

Factor Analysis

The structure of the AIMS2 is based on a factor analysis that identified the 12 primary dimensions of health status affected by arthritis. These factors group related items into distinct, clinically meaningful scales, allowing for subscale scoring and detailed profile reporting.

The 12 domains measured by AIMS2 are:

• MOBILITY LEVEL
• WALKING AND BENDING
• HAND AND FINGER FUNCTION
• ARM FUNCTION
• SELF-CARE TASKS
• HOUSEHOLD TASKS
• SOCIAL ACTIVITY
• SUPPORT FROM FAMILY AND FRIENDS
• ARTHRITIS PAIN
• WORK
• LEVEL OF TENSION
• MOOD

This comprehensive structure allows researchers to analyze specific areas of impact, rather than relying solely on a single, global score.

Instrument

Test Type: Health Status Questionnaire / Patient Reported Outcome (PRO) Measure

Format: Self-administered questionnaire, Likert-type scales (ranging typically from 5-point frequency or severity scales to satisfaction scales)

Language Available: English, Persian (Mousavi et al., 2009), and likely numerous other translations given its widespread use in international rheumatology research.

Population Group: Patients diagnosed with various forms of arthritis or other rheumatic diseases.

Age Group: Adults (typically used for middle-aged and older adults, reflecting the prevalence of chronic arthritis).

Population Details: Applicable across different arthritis types, including Rheumatoid Arthritis, Osteoarthritis, Lupus, Fibromyalgia, and Gout.

Test Methodology: Patients respond to questions regarding their experiences and functional abilities during the past month. Scoring involves summing or averaging item responses within each subscale, which may require transformation depending on the scale version used.

Keywords

AIMS, Outcome Assessment, Musculoskeletal Disorders, Patient Function, Rheumatoid Disease, Health status, Psychometric properties, Pain Assessment, Activities of Daily Living (ADLs)

Authors

Author ORCID Identifier: N/A (Information not provided in source)

Affiliation Email addresses: N/A (Information not provided in source)

Correspondence Address: Contact original publishing institutions or primary authors (e.g., Robert F. Meenan).

Permissions & Fee and Test Year

The original AIMS was introduced in 1980, while the revised and expanded AIMS2 was published in 1992. The validated AIMS2 Short Form (AIMS2-SF) was published in 1997. For information regarding permissions and usage fees, researchers and clinicians should contact the scale authors or the copyright holder, typically the publisher of the journal Arthritis & Rheumatism.

The instrument itself, including the original PDF documentation, can be found via external resources. The original PDF can be downloaded here: www.a4ebm.org/sites/default/files/Measuring%20Health.pdf.

Reference’s

• Meenan, R.F., Gertman, P.M., Mason, J.H. (1980). Measuring health status in arthritis: the Arthritis Impact Measurement Scales. Arthritis Rheum, 23:146–152.
• Meenan, R.F. (1982). The AIMS approach to health status measurement: conceptual background and measurement properties. J Rheumatol, 9:785–788.
• Meenan, R.F. (1986). New approaches to outcome assessment: the AIMS questionnaire for arthritis. Adv Intern Med, 31:167–185.
• Meenan, R.F., Mason, J.H., Anderson, J.J, et al. (1992). AIMS2: the content and properties of a revised and expanded Arthritis Impact Measurement Scales health status questionnaire. Arthritis Rheum, 35:1–10.
• Guillemin, Francis., Coste, Joel., Pouchot, Jacques, et al. (1997). A Short Form of the Arthritis Impact Measurement Scales 2. ARTHRITIS & RHEUMATISM, 40(7): 1267-1274.
• Ren, X.S., Kazis, L., Meenan, R.F. (1999). Short-form Arthritis Impact Measurement Scales 2: tests of reliability and validity among patients with osteoarthritis. Arthritis Care Res, 12(3):163-71.
• McDowell, Ian. (2006). Measuring Health: A Guide to Rating Scales and Questionnaires, Third Edition. OXFORD UNIVERSITY PRESS.
• Mousavi, S. J.; Parnianpour, M.; AskaryAshtiani, A. R.; Hadian, M. R.; Rostamian, A. & Montazeri, A. (2009). Translation and validation study of the Persian version of the Arthritis Impact Measurement Scales 2 (AIMS2) in patients with osteoarthritis of the knee. Musculoskeletal Disorders, 10, 95, 5-9.

Items of the Arthritis Impact Measurement Scale (AIMS2)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

Arthritis Impact Measurement Scale Short Form (AIMS2-SF)

1. How often were you physically able to drive a car or use public transportation?
2. How often were you in a bed or chair for most or all of the day?
3. Did you have trouble doing vigorous activities such as running, lifting heavy objects, or participating in strenuous sports?
4. Did you have trouble either walking several blocks or climbing a few flights of stairs?
5. Were you unable to walk unless assisted by another person or by a cane, crutches, or walker?
6. Could you easily write with a pen or pencil?
7. Could you easily button a shirt or blouse?
8. Could you easily turn a key in a lock?
9. Could you easily comb or brush your hair?
10. Could you easily reach shelves that were above your head?
11. Did you need help to get dressed?
12. Did you need help to get in or out of bed?
13. How often did you have severe pain from your arthritis?
14. How often did your morning stiffness last more than one hour from the time you woke up?
15. How often did your pain make it difficult for you to sleep?
16. How often have you felt tense or high strung?
17. How often have you been bothered by nervousness or your nerves?
18. How often have you been in low or very low spirits?
19. How often have you enjoyed the things you do?
20. How often did you feel a burden to others?
21. How often did you get together with friends or relatives?
22. How often were you on the telephone with close friends or relatives?
23. How often did you go to a meeting of a church, club, team or other group?
24. Did you feel that your family or friends were sensitive to your personal needs?
25. How often were you unable to do any paid work, housework, or school work?
26. On the days that you did work, how often did you have to work a shorter day?

Arthritis Impact Measurement Scale-2 (AIMS)

These questions refer to MOBILITY LEVEL

(1) All days, (2) Most Days, (3) Some Days, (4) Few Days, (5) No Days

DURING THE PAST MONTH. . . .

1. How often were you physically able to drive a car or use public transportation?
2. How often were you out of the house for at least part of the day?
3. How often were you able to do errands in the neighborhood?
4. How often did someone have to assist you to get around outside your home?
5. How often were you in a bed or chair for most or all of the day?

These questions refer to WALKING AND BENDING

(1) All days, (2) Most Days, (3) Some Days, (4) Few Days, (5) No Days

DURING THE PAST MONTH. . . .

6. Did you have trouble doing vigorous activities such as running, lifting heavy objects, or participating in strenuous sports?
7. Did you have trouble either walking several blocks or climbing a few flights of stairs?
8. Did you have trouble bending, lifting or stooping?
9. Did you have trouble either walking one block or climbing one flight of stairs?
10. Were you unable to walk unless assisted by another person or by a cane, crutches, or walker?

These questions refer to HAND AND FINGER FUNCTION

(1) All days, (2) Most Days, (3) Some Days, (4) Few Days, (5) No Days

DURING THE PAST MONTH. . . .

11. Could you easily write with a pen or pencil?
12. Could you easily button a shirt or blouse?
13. Could you easily turn a key in a lock?
14. Could you easily tie a knot or a bow?
15. Could you easily open a new jar of food?

These questions refer to ARM FUNCTION

(1) All days, (2) Most Days, (3) Some Days, (4) Few Days, (5) No Days

DURING THE PAST MONTH. . . .

16. Could you easily wipe your mouth with a napkin?
17. Could you easily put on a pullover sweater?
18. Could you easily comb or brush your hair?
19. Could you easily scratch your low back with your hand?
20. Could you easily reach shelves that were above your head?

These questions refer to SELF-CARE TASKS

(1) Always, (2) Very Often, (3) Sometimes, (4) Almost Never, (5) Never

DURING THE PAST MONTH. . . .

21. Did you need help to take a bath or shower?
22. Did you need help to get dressed?
23. Did you need help to use the toilet?
24. Did you need help to get in or out of bed?

These questions refer to HOUSEHOLD TASKS

(1) Always, (2) Very Often, (3) Sometimes, (4) Almost Never, (5) Never

DURING THE PAST MONTH. . . .

25. If you had the necessary transportation, could you go shopping for groceries without help?
26. If you had kitchen facilities, could you prepare your own meals without help?
27. If you had household tools and appliances, could you do your own housework without help?
28. If you had laundry facilities, could you do your own laundry without help?

These questions refer to SOCIAL ACTIVITY

(1) All days, (2) Most Days, (3) Some Days, (4) Few Days, (5) No Days

DURING THE PAST MONTH. . . .

29. How often did you get together with friends or relatives?
30. How often did you have friends or relatives over to your home?
31. How often did you visit friends or relatives in their homes?
32. How often were you on the telephone with close friends or relatives?
33. How often did you go to a meeting of a church, club, team or other group?

These questions refer to SUPPORT FROM FAMILY AND FRIENDS

(1) Always, (2) Very Often, (3) Sometimes, (4) Almost Never, (5) Never

DURING THE PAST MONTH. . . .

34. Did you feel that your family or friends would be around you if you needed assistance?
35. Did you feel that your family or friends were sensitive to your personal needs?
36. Did you feel that your family or friends were interested in helping you solve problems?
37. Did you feel that your family or friends understood the effects of your arthritis?

These questions refer to ARTHRITIS PAIN

DURING THE PAST MONTH. . . .

38. How would you describe the arthritis pain you usually had? (1) Severe, (2) Moderate, (3) Mild, (4) Very Mild, (5) None

DURING THE PAST MONTH. . . .

(1) All days, (2) Most Days, (3) Some Days, (4) Few Days, (5) No Days

39. How often did you have severe pain from your arthritis?
40. How often did you have pain in two or more joints at the same time?
41. How often did your morning stiffness last more than one hour from the time you woke up?
42. How often did your pain make it difficult for you to sleep?

These questions refer to WORK

DURING THE PAST MONTH. . . .

43. What has been your main form of work? (1) Paid Work, (2) Housework, (3) School work, (4) Unemployed, (5) Disabled, (6) Retired

If you answered unemployed, disabled or retired, please skip the next four questions and go to the next page.

(1) All days, (2) Most Days, (3) Some Days, (4) Few Days, (5) No Days

DURING THE PAST MONTH. . . .

44. How often were you unable to do any paid work, housework, or school work?
45. On the days that you did work, how often did you have to work a shorter day?
46. On the days that you did work, how often were you unable to do your work as carefully and accurately as you would like?
47. On the days that you did work, how often did you have to change the way your paid work, housework or school work is usually done?

These questions refer to LEVEL OF TENSION

(1) Always, (2) Very Often, (3) Sometimes, (4) Almost Never, (5) Never

DURING THE PAST MONTH. . . .

48. How often have you felt tense or high strung?
49. How often have you been bothered by nervousness or your nerves?
50. How often were you able to relax without difficulty?
51. How often have you felt relaxed and free of tension?
52. How often have you felt calm and peaceful?

These questions refer to MOOD

(1) Always, (2) Very Often, (3) Sometimes, (4) Almost Never, (5) Never

DURING THE PAST MONTH. . . .

53. How often have you enjoyed the things you do?
54. How often have you been in low or very low spirits?
55. How often did you feel that nothing turned out the way you wanted it to?
56. How often did you feel that others would be better off if you were dead?
57. How often did you feel so down in the dumps that nothing would cheer you up?

These questions refer to SATISFACTION WITH EACH HEALTH AREA.

(1) Very Satisfied, (2) Somewhat Satisfied, (3) Neither Satisfied Nor Dissatisfied, (4) Somewhat Dissatisfied, (5) Very Dissatisfied

DURING THE PAST MONTH…

58. How satisfied have you been with each of these areas of your health?

(0) Not A Problem For Me, (1) Due Entirely To Other Causes, (2) Due Largely To Other Causes, (3) Due Partly To Arthritis And Partly To Other Causes, (4) Due Largely To My Arthritis, (5) Due Entirely To My Arthritis

• MOBILITY LEVEL (example: do errands)
• WALKING AND BENDING (example: climb stairs)
• HAND AND FINGER FUNCTION (example: tie a bow)
• ARM FUNCTION (example: comb hair)
• SELF-CARE (example: take bath)
• HOUSEHOLD TASKS (example: housework)
• SOCIAL ACTIVITY (example: visit friends)
• SUPPORT FROM FAMILY (example: help with problems)
• ARTHRITIS PAIN (example: joint pain)
• WORK (example: reduce hours)
• LEVEL OF TENSION (example: felt tense)
• MOOD (example: down in dumps)

These questions refer to ARTHRITIS IMPACT ON EACH AREA OF HEALTH.

(0) Not A Problem For Me, (1) Due Entirely To Other Causes, (2) Due Largely To Other Causes, (3) Due Partly To Arthritis And Partly To Other Causes, (4) Due Largely To My Arthritis, (5) Due Entirely To My Arthritis

DURING THE PAST MONTH…

59. How much of your problem in each area of health was due to your arthritis?

• MOBILITY LEVEL (example: do errands)
• WALKING AND BENDING (example: climb stairs)
• HAND AND FINGER FUNCTION (example: tie a bow)
• ARM FUNCTION (example: comb hair)
• SELF-CARE (example: take bath)
• HOUSEHOLD TASKS (example: housework)
• SOCIAL ACTIVITY (example: visit friends)
• SUPPORT FROM FAMILY (example: help with problems)
• ARTHRITIS PAIN (example: joint pain)
• WORK (example: reduce hours)
• LEVEL OF TENSION (example: felt tense)
• MOOD (example: down in dumps)

You have now answered questions about different AREAS OF YOUR HEALTH.

check= 1, blank= 0

60. AREAS OF HEALTH THREE AREAS FOR IMPROVEMENT

• MOBILITY LEVEL (example: do errands)
• WALKING AND BENDING (example: climb stairs)
• HAND AND FINGER FUNCTION (example: tie a bow)
• ARM FUNCTION (example: comb hair)
• SELF-CARE (example: take bath)
• HOUSEHOLD TASKS (example: housework)
• SOCIAL ACTIVITY (example: visit friends)
• SUPPORT FROM FAMILY (example: help with problems)
• ARTHRITIS PAIN (example: joint pain)
• WORK (example: reduce hours)
• LEVEL OF TENSION (example: felt tense)
• MOOD (example: down in dumps)

These questions refer to your CURRENT and FUTURE HEALTH.

61. In general would you say that your HEALTH NOW is excellent, good, Fair or Poor? (1) Excellent, (2) Good, (3) Fair, (4) Poor
62. How satisfied are you with your HEALTH NOW? (1) Very Satisfied, (2) Somewhat Satisfied, (3) Neither Satisfied Nor Dissatisfied, (4) Somewhat Dissatisfied, (5) Very Dissatisfied
63. How much of your problem with your HEALTH NOW is due to your arthritis? (0) Not A Problem For Me, (1) Due Entirely To Other Causes, (2) Due Largely To Other Causes, (3) Due Partly To Arthritis And Partly To Other Causes, (4) Due Largely To My Arthritis, (5) Due Entirely To My Arthritis
64. In general do you expect that your HEALTH 10 YEARS FROM NOW will be excellent, good, fair or poor? (1) Excellent, (2) Good, (3) Fair, (4) Poor
65. How big a problem do you expect your arthritis to be 10 YEARS FROM NOW? (1) No Problem At All, (2) Minor Problem, (3) Moderate Problem, (4) Major Problem

This question refers to OVERALL ARTHRITIS IMPACT.

66. CONSIDERING ALL THE WAYS THAT YOUR ARTHRITIS AFFECTS YOU, how well are you doing compared to other people your age? (1) Very Well, (2) Well, (3) Fair, (4) Poor, (5) Very Poorly

67. What is the main kind of arthritis that you have?

check= 1, blank= 0

• Rheumatoid Arthritis
• Osteoarthritis/Degenerative Arthritis
• Systemic Lupus Erythematosis
• Fibromyalgia
• Scleroderma
• Psoriatic Arthritis
• Reiter’s Syndrome
• Gout
• Low Back Pain
• Tendonitis/Bursitis
• Osteoporosis
• Other

68. How many years have you had arthritis? . . .

DURING THE PAST MONTH… (1) (2) (3) (4) (5)

69. How often have you had to take MEDICATION for your arthritis? (1) All Days, (2) Most Days, (3) Some Days, (4) Few Days, (5) No Days

Please check (X) yes or no for each question.

70. Is your health currently affected by any of the following medical problems?

(1) Yes, (2) No

• High blood pressure
• Heart disease
• Mental illness
• Diabetes
• Cancer
• Alcohol or drug use
• Lung disease
• Kidney disease
• Liver disease
• Ulcer or other stomach disease
• Anaemia or other blood disease

71. Do you take medicine every day for any problem other than your arthritis? (1) Yes, (2) No
72. Did you see a doctor more than three times last year for any problem other than arthritis? (1) Yes, (2) No

Please provide the following information about yourself:

73. What is your age at this time?
74. What is your sex?
75. What is your racial background?
76. What is your current marital status?
77. What is the highest level of education you received?
78. What is your approximate family income including wages, disability payment, retirement income and welfare?