Hoos Hip Survey
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4Hip dysfunction and Osteoarthritis Outcome Score (HOOS), English version LK 2.0
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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
Often
Always
□
□
□
□
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S2. Difficulties spreading legs wide apart
Severe
Extreme
None
Mild
Moderate
□
□
□
□
□
S3. Difficulties to stride out when walking
Severe
Extreme
None
Mild
Moderate
□
□
□
□
□
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?
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
□
□
□
□
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