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KOOS

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


Knee injury and Osteoarthritis Outcome Score (KOOS), English version LK1.0 1
KOOS KNEE SURVEY


Today’s date: _____/______/______ Date of birth: _____/______/______


Name: ____________________________________________________

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

Symptoms
These questions should be answered thinking of your knee symptoms during
the last week.

S1. Do you have swelling in your knee?
Never
‡
Rarely
‡
Sometimes
‡
Often
‡
Always
‡

S2. Do you feel grinding, hear clicking or any other type of noise when your knee
moves?
Never
‡
Rarely
‡
Sometimes
‡
Often
‡
Always
‡

S3. Does your knee catch or hang up when moving?
Never
‡
Rarely
‡
Sometimes
‡
Often
‡
Always
‡

S4. Can you straighten your knee fully?
Always
‡
Often
‡
Sometimes
‡
Rarely
‡
Never
‡

S5. Can you bend your knee fully?
Always
‡
Often
‡
Sometimes
‡
Rarely
‡
Never
‡

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

S6. How severe is your knee joint stiffness after first wakening in the morning?
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

S7. How severe is your knee stiffness after sitting, lying or resting later in the day?
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

Knee injury and Osteoarthritis Outcome Score (KOOS), English version LK1.0 2
Pain
P1. How often do you experience knee pain?
Never
‡
Monthly
‡
Weekly
‡
Daily
‡
Always
‡

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

P2. Twisting/pivoting on your knee
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

P3. Straightening knee fully
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

P4. Bending knee fully
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

P5. Walking on flat surface
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

P6. Going up or down stairs
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

P7. At night while in bed
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

P8. Sitting or lying
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

P9. Standing upright
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 knee.

A1. Descending stairs
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

A2. Ascending stairs
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

Knee injury and Osteoarthritis Outcome Score (KOOS), English version LK1.0 3
For each of the following activities please indicate the degree of difficulty you
have experienced in the last week due to your knee.

A3. Rising from sitting
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

A4. Standing
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

A5. Bending to floor/pick up an object
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

A6. Walking on flat surface
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

A7. Getting in/out of car
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

A8. Going shopping
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

A9. Putting on socks/stockings
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

A10. Rising from bed
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

A11. Taking off socks/stockings
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

A12. Lying in bed (turning over, maintaining knee position)
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

A13. Getting in/out of bath
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

A14. Sitting
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

A15. Getting on/off toilet
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

Knee injury and Osteoarthritis Outcome Score (KOOS), English version LK1.0 4
For each of the following activities please indicate the degree of difficulty you
have experienced in the last week due to your knee.

A16. Heavy domestic duties (moving heavy boxes, scrubbing floors, etc)
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

A17. 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 knee.
SP1. Squatting
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

SP2. Running
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

SP3. Jumping
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

SP4. Twisting/pivoting on your injured knee
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

SP5. Kneeling
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡

Quality of Life
Q1. How often are you aware of your knee problem?
Never
‡
Monthly
‡
Weekly
‡
Daily
‡
Constantly
‡

Q2. Have you modified your life style to avoid potentially damaging activities
to your knee?
Not at all
‡
Mildly
‡
Moderately
‡
Severely
‡
Totally
‡

Q3. How much are you troubled with lack of confidence in your knee?
Not at all
‡
Mildly
‡
Moderately
‡
Severely
‡
Extremely
‡

Q4. In general, how much difficulty do you have with your knee?
None
‡
Mild
‡
Moderate
‡
Severe
‡
Extreme
‡
Thank you very much for completing all the questions in this questionnaire.