Background:
The model disability survey (mds) is a tool based on the biopsychosocial model and aims to measure functionality and human disability. the mds-brasil module (4000) has topics related to peoples ability and performance to carry out daily activities considering physical, psychological and socio-environmental conditions.

Objective:
To describe data from the pre-test phase of module 4000 (functionality) of the model disability survey brasil (mds-brasil) instrument.

Methods:
This study included 30 individuals residing in northeastern brazil, with or without disabilities, who were cognitively able to respond to the questionnaire, and participants who refused or gave up the interview were excluded from the study. The participant was contacted for invitation and appointment of the date and place of the interview, where the questionnaire, the manual and the mds-brasil presentation cards were used, translated and cross-culturally adapted to the brazilian population. the responses from module 4000 of the mds-brasil were analyzed.

Results:
Of the 30 participants, 73.3% lived in rio grande do norte, 13.3% in ceará and 13.3% in paraíba. Females predominated with 83.3%, single 56.7%, 30% had higher education, 53.3% were considered brown and 26.7% worked for an employer. Some difficulties were reported by them, among which 33.3% of the participants said they had a problem walking short distances, 20% to carry out activities using their hands, 16.7% to do personal hygiene and get dressed, 53, 3% for seeing from afar, 73.3% for feeling pain in everyday life, 53.3% for sleeping, 50% revealed difficulties in understanding and 53.3% in remembering to do important things.

Conclusion:
The results of the pre-test allowed a first contact with the community and, through module 4000 of the mds-brasil, it was possible to identify the main limitations of activities and social participation that influence human functionality.