OBJECTIVES The objective of this study is to determine which physical assessment Clinical Outcomes Assessment (COA) questionnaire items are most translatable. METHODS Eighteen (18) physical assessment items were analyzed, using back-translations to determine conceptual equivalency with the source text. Previous studies have regarded 80% source conceptual equivalency as a translatability benchmark. Translator feedback regarding cultural appropriateness also influenced whether certain physical assessment items were optimal for use in questionnaires, as some items might be translatable, but not appropriate for the target country. RESULTS Physical assessment items were grouped into three categories: highly translatable, moderately translatable, and problematic. Highly translatable examples, “running errands,” “getting around town” and “washing yourself” were translated with conceptual equivalency 100% of the time, and were considered culturally appropriate for all languages. Moderately translatable items, such as “taking a trip” may be misconstrued, as the distance implied may differ across languages. “Bathe yourself” was translated with 87% conceptual equivalency, and may be misunderstood as “taking a bath,” when the intention is to clean oneself. Problematic items, such as “going out,” translated with conceptual equivalency only 76% of the time, requiring a destination or activity to be comprehensible in other languages. “Walking a block,” although achieving 84% conceptual equivalency, is not applicable nor understood in many languages. When measuring distance walked, it is recommended to be specific, using examples such as 100 meters or a kilometer. CONCLUSIONS Specific concepts appear to be more translatable and universal, such as “getting around town” and “walking 100 meters.”  Items left open for interpretation, such as “bathing yourself” or “taking a trip” can cause moderate translation difficultiesAdditionally, many languages cannot coherently translate less specific items, such as “going out,” or translate culturally specific items. Although “walking a block” is translatable, such an example is unlikely to be understood in many languages.