Hoos Hip Survey Page 2
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4Hip dysfunction and Osteoarthritis Outcome Score (HOOS), English version LK 2.0
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What amount of hip pain have you experienced the last week during the following
activities?
P3. Bending your hip fully
None
Mild
Moderate
Extreme
Severe
□
□
□
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P4. Walking on a flat surface
Moderate
Extreme
None
Mild
Severe
□
□
□
□
□
P5. Going up or down stairs
Moderate
Extreme
None
Mild
Severe
□
□
□
□
□
P6. At night while in bed
Moderate
Extreme
None
Mild
Severe
□
□
□
□
□
P7. Sitting or lying
Moderate
Extreme
None
Mild
Severe
□
□
□
□
□
P8. Standing upright
Moderate
Extreme
None
Mild
Severe
□
□
□
□
□
P9. Walking on a hard surface (asphalt, concrete, etc.)
Extreme
None
Mild
Moderate
Severe
□
□
□
□
□
P10. Walking on an uneven surface
Extreme
Moderate
None
Mild
Severe
□
□
□
□
□
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
Mild
Moderate
Severe
Extreme
□
□
□
□
□
A2. Ascending stairs
None
Mild
Moderate
Severe
Extreme
□
□
□
□
□
A3. Rising from sitting
None
Mild
Moderate
Severe
Extreme
□
□
□
□
□
A4. Standing
Mild
Moderate
Severe
Extreme
None
□
□
□
□
□
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Parent category: Medical