HOOS Hip Survey
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HOOS Hip Survey
* Required Information
Symptoms
These questions should be answered thinking of your hip symptoms and difficulties during the last week.
*
Do you feel grinding, hear clicking or any other type of noise from your hip?
Never
Rarely
Sometimes
Often
Always
*
Difficulties spreading legs wide apart
None
Mild
Moderate
Severe
Extreme
*
Difficulties to stride out when walking
None
Mild
Moderate
Severe
Extreme
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.
*
How severe is your hip joint stiffness after first wakening in the morning?
None
Mild
Moderate
Severe
Extreme
*
How severe is your hip stiffness after sitting, lying or resting later in the day?
None
Mild
Moderate
Severe
Extreme
Pain
What amount of hip pain have you experienced the last week during the following activities?
*
How often is your hip painful?
Never
Monthly
Weekly
Daily
Always
*
Straightening your hip fully
None
Mild
Moderate
Severe
Extreme
*
Bending your hip fully
None
Mild
Moderate
Severe
Extreme
*
Walking on a flat surface
None
Mild
Moderate
Severe
Extreme
*
Going up or down stairs
None
Mild
Moderate
Severe
Extreme
*
At night while in bed
None
Mild
Moderate
Severe
Extreme
*
Sitting or lying
None
Mild
Moderate
Severe
Extreme
*
Standing upright
None
Mild
Moderate
Severe
Extreme
*
Walking on a hard surface (asphalt, concrete, etc.)
None
Mild
Moderate
Severe
Extreme
*
Walking on an uneven surface
None
Mild
Moderate
Severe
Extreme
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.
*
Descending stairs
None
Mild
Moderate
Severe
Extreme
*
Ascending stairs
None
Mild
Moderate
Severe
Extreme
*
Rising from sitting
None
Mild
Moderate
Severe
Extreme
*
Standing
None
Mild
Moderate
Severe
Extreme
*
Bending to the floor/pick up an object
None
Mild
Moderate
Severe
Extreme
*
Walking on a flat surface
None
Mild
Moderate
Severe
Extreme
*
Getting in/out of car
None
Mild
Moderate
Severe
Extreme
*
Going shopping
None
Mild
Moderate
Severe
Extreme
*
Putting on socks/stockings
None
Mild
Moderate
Severe
Extreme
*
Rising from bed
None
Mild
Moderate
Severe
Extreme
*
Taking off socks/stockings
None
Mild
Moderate
Severe
Extreme
*
Lying in bed (turning over, maintaining hip position)
None
Mild
Moderate
Severe
Extreme
*
Getting in/out of bath
None
Mild
Moderate
Severe
Extreme
*
Sitting
None
Mild
Moderate
Severe
Extreme
*
Getting on/off toilet
None
Mild
Moderate
Severe
Extreme
*
Heavy domestic duties (moving heavy boxes, scrubbing floors, etc)
None
Mild
Moderate
Severe
Extreme
*
Light domestic duties (cooking, dusting, etc)
None
Mild
Moderate
Severe
Extreme
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 last week due to your hip.
*
Squatting
None
Mild
Moderate
Severe
Extreme
*
Running
None
Mild
Moderate
Severe
Extreme
*
Twisting/pivoting on loaded leg
None
Mild
Moderate
Severe
Extreme
*
Walking on uneven surface
None
Mild
Moderate
Severe
Extreme
Quality of Life
*
How often are you aware of your hip problem?
Never
Monthly
Weekly
Daily
Constantly
*
Have you modified your life style to avoid activities potentially damaging to your hip?
Not at all
Mildly
Moderately
Severely
Totally
*
How much are you troubled with lack of confidence in your hip?
Not at all
Mildly
Moderately
Severely
Extremely
*
In general, how much difficulty do you have with your hip?
None
Mild
Moderate
Severe
Extreme
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