HOOS Hip Outcomes

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    Today’s date: Left or right hip: LeftRight
    Full Name: Email:

    INSTRUCTIONS: This survey asks for your view about your hip. This information will help us keep track of how you feel about your hip and how well you are able to do your usual activities.
    Answer every question by ticking the appropriate box, only one box for each question. If you are uncertain about how to answer a question, please give the best answer you can.

    Symptoms

    These questions should be answered thinking of your hip symptoms and difficulties during the last week.

    S1. Do you feel grinding, hear clicking or any other type of noise from your hip?
    NeverRarelySometimesOftenAlways

    S2. Difficulties spreading legs wide apart?
    NoneMildModerateSevereExtreme

    S3. Difficulties to stride out when walking?
    NoneMildModerateSevereExtreme

    Stiffness

    The following questions concern the amount of joint stiffness you have experienced during the last week in your hip. Stiffness is a sensation of restriction or slowness in the ease with which you move your hip joint.

    S4. How severe is your hip joint stiffness after first wakening in the morning?
    NoneMildModerateSevereExtreme

    S5. How severe is your hip stiffness after sitting, lying or resting later in the day?
    NoneMildModerateSevereExtreme

    Pain

    P1. How often is your hip painful?
    NeverRarelySometimesOftenAlways

    What amount of knee pain have you experienced the last week during the following activities?

    P2. Straightening your hip fully
    NoneMildModerateSevereExtreme

    What amount of hip pain have you experienced the last week during the following
    activities?

    P3. Bending your hip fully
    NoneMildModerateSevereExtreme

    P4. Walking on a flat surface
    NoneMildModerateSevereExtreme

    P5. Going up or down stairs
    NoneMildModerateSevereExtreme

    P6. At night while in bed
    NoneMildModerateSevereExtreme

    P7. Sitting or lying
    NoneMildModerateSevereExtreme

    P8. Standing upright
    NoneMildModerateSevereExtreme

    P9. Walking on a hard surface (asphalt, concrete, etc.)
    NoneMildModerateSevereExtreme

    P10. Walking on an uneven surface
    NoneMildModerateSevereExtreme

    Function, daily living

    The following questions concern your physical function. By this we mean your ability to move around and to look after yourself. For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your hip.

    A1. Descending stairs
    NoneMildModerateSevereExtreme

    A2. Ascending stairs
    NoneMildModerateSevereExtreme

    A3. Rising from sitting
    NoneMildModerateSevereExtreme

    A4. Standing
    NoneMildModerateSevereExtreme

    For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your hip.

    A5. Bending to the floor/pick up an object
    NoneMildModerateSevereExtreme

    A6. Walking on a flat surface
    NoneMildModerateSevereExtreme

    A7. Getting in/out of car
    NoneMildModerateSevereExtreme

    A8. Going shopping
    NoneMildModerateSevereExtreme

    A9. Putting on socks/stockings
    NoneMildModerateSevereExtreme

    A10. Rising from bed
    NoneMildModerateSevereExtreme

    A11. Taking off socks/stockings
    NoneMildModerateSevereExtreme

    A12. Lying in bed (turning over, maintaining hip position)
    NoneMildModerateSevereExtreme

    A13. Getting in/out of bath
    NoneMildModerateSevereExtreme

    A14. Sitting
    NoneMildModerateSevereExtreme

    A15. Getting on/off toilet
    NoneMildModerateSevereExtreme

    A16. Heavy domestic duties (moving heavy boxes, scrubbing floors, etc)
    NoneMildModerateSevereExtreme

    A17. Light domestic duties (cooking, dusting, etc)
    NoneMildModerateSevereExtreme

    Function, sports and recreational activities

    The following questions concern your physical function when being active on a higher level. The questions should be answered thinking of what degree of difficulty you have experienced during the due to your hip.

    SP1. Squatting
    NoneMildModerateSevereExtreme

    SP2. Running
    NoneMildModerateSevereExtreme

    SP3. Twisting/pivoting on loaded leg
    NoneMildModerateSevereExtreme

    SP4. Walking on uneven surface
    NoneMildModerateSevereExtreme

    Quality of Life

    Q1. How often are you aware of your hip problem?
    NeverMonthlyWeeklyDailyConstantly

    Q2. Have you modified your life style to avoid activities potentially damaging to your hip?
    Not at allMildlyModerateSeverelyTotally

    Q3. How much are you troubled with lack of confidence in your hip?
    Not at allMildlyModerateSeverelyExtremely

    Q4. In general, how much difficulty do you have with your hip?
    Not at allMildlyModerateSeverelyExtremely