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HOOS

HOOS - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Questionnaires


Hip dysfunction and Osteoarthritis Outcome Score (HOOS), English version LK 2.0
HOOS HIP SURVEY
Today's date: _____/______/______ Date of birth: _____/______/________
Name: _______________________________________________________
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?
Never

Rarely

Sometimes

1
S2. Difficulties spreading legs wide apart
None

Mild

Moderate

S3. Difficulties to stride out when walking
None

Stiffness
Mild

Moderate

Often

Severe

Severe

Always

Extreme

Extreme

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?
None

Mild

Moderate

Severe

Extreme

S5. How severe is your hip stiffness after sitting, lying or resting later in the day?
None

Mild

Moderate

Severe

Extreme

Pain
P1. How often is your hip painful?
Never

Monthly

Weekly

Daily

Always

What amount of hip pain have you experienced the last week during the following
activities?
P2. Straightening your hip fully
None

Mild

Moderate

Severe

Extreme



Hip dysfunction and Osteoarthritis Outcome Score (HOOS), English version LK 2.0
What amount of hip pain have you experienced the last week during the following
activities?
P3. Bending your hip fully
None

Mild

2
P4. Walking on a flat surface
None

Mild

P5. Going up or down stairs
None

Mild

P6. At night while in bed
None

P7. Sitting or lying
None

P8. Standing upright
None

Mild

Mild

Mild

Moderate

Moderate

Moderate

Moderate

Moderate

Moderate

P9. Walking on a hard surface (asphalt, concrete, etc.)
None

Mild

P10. Walking on an uneven surface
None

Mild

Moderate

Moderate

Severe

Severe

Severe

Severe

Severe

Severe

Severe

Severe

Extreme

Extreme

Extreme

Extreme

Extreme

Extreme

Extreme

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.
A1. Descending stairs
None

A2. Ascending stairs
None

A3. Rising from sitting
None

A4. Standing
None

Mild

Mild

Mild

Mild

Moderate

Moderate

Moderate

Moderate

Severe

Severe

Severe

Severe

Extreme

Extreme

Extreme

Extreme


Hip dysfunction and Osteoarthritis Outcome Score (HOOS), English version LK 2.0
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
None

Mild

3
A6. Walking on a flat surface
None

Mild

A7. Getting in/out of car
None

A8. Going shopping
None

Mild

Mild

A9. Putting on socks/stockings
None

A10. Rising from bed
None

Mild

Mild

A11. Taking off socks/stockings
None

Mild

Moderate

Moderate

Moderate

Moderate

Moderate

Moderate

Moderate

A12. Lying in bed (turning over, maintaining hip position)
None

Mild

A13. Getting in/out of bath
None

A14. Sitting
None

Mild

Mild

A15. Getting on/off toilet
None

Mild

Moderate

Moderate

Moderate

Moderate

Severe

Severe

Severe

Severe

Severe

Severe

Severe

Severe

Severe

Severe

Severe

A16. Heavy domestic duties (moving heavy boxes, scrubbing floors, etc)
None

Mild

Moderate

A17. Light domestic duties (cooking, dusting, etc)
None

Mild

Moderate

Severe

Severe

Extreme

Extreme

Extreme

Extreme

Extreme

Extreme

Extreme

Extreme

Extreme

Extreme

Extreme

Extreme

Extreme



Hip dysfunction and Osteoarthritis Outcome Score (HOOS), English version LK 2.0
4
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.
SP1. Squatting
None

SP2. Running
None

Mild

Mild

SP3. Twisting/pivoting on loaded leg
None

Mild

SP4. Walking on uneven surface
None

Quality of Life
Mild

Moderate

Moderate

Moderate

Moderate

Severe

Severe

Severe

Severe

Extreme

Extreme

Extreme

Extreme

Q1. How often are you aware of your hip problem?
Never

Monthly

Weekly

Daily

Constantly

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

Mildly

Moderately

Severely

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

Mildly

Moderately

Severely

Q4. In general, how much difficulty do you have with your hip?
None

Mild

Moderate

Severe

Totally

Extremely

Extreme

Thank you very much for completing all the questions
in this questionnaire.