These Questions Assess Your Symptoms & Stiffness

HOOS HIP SURVEY

This is an internationally standardised hip survey that assists in evaluating your hip function. The questions relate to your hip symptoms and function during the last week. Please answer every question. If you are uncertain, please give the best answer you can.

Symptoms These questions assess your symptoms & stiffness

S1. Do you feel grinding, hear clicking or any other type of noise from your hip? S2. Do you have difficulties in spreading legs wide apart? S3. Do you have difficulties to stride out when walking? S4. How severe is your joint stiffness after first waking in the morning? S5. How severe is your hip stiffness after sitting, lying or resting later in the day?

Pain How painful are the following activities?

P1. How often is your hip joint painful? P2. Straightening you hip fully? P3. Bending your hip fully? P4. Walking on a flat surface? P5. Going up and down stairs?

P6. At night while in bed? P7. How painful is sitting or lying? P8. How painful is standing upright? P9. How painful is walking on a hard surface? P10.How painful is walking on an uneven surface? Function and daily living How difficult do you find the following?

A1. Descending stairs? A2. Ascending stairs? A3. Rising for sitting? A4. Standing? A5. Bending to the floor/ picking up an object?

A6. Walking on a flat surface? A7. Getting in/ out of a car? A8. Going shopping? A9. Putting on shoes/ socks? A10. Rising from bed?

A11. Taking off shoes/ socks? A12. Lying in bed? A13. Getting in/ out of bath? A14. Sitting? A15. Getting on/ off toilet?

A16. Heavy domestic duties (moving boxes, scrubbing floors etc)? A17. Light domestic duties (cooking, dusting etc)?

Function, sports and recreational activities The following assess you higher level hip function. How much difficulty to you experience with the following?

SP1. Squatting? SP2. Running? SP3. Twisting/ pivoting on loaded leg? SP4. Walking on a uneven surface? Quality of life The following assess the overall impact your hip is having on your life.

Q1. How often are you aware of your hip problem? Q2. Have you modified your lifestyle to avoid activities potentially damaging your hip? Q3. How much are you troubled with lack of confidence in your hip? Q4. In general, how much difficulty do you have with your hip?

Thank you very much for completing this questionnaire

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