HOOS Hip Survey

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 entering the number that best fits your situation, using the scales above each section. If you are uncertain about how to answer a question, please give the best answer you can.

Full Name *

Date *

These questions should be answered thinking of your hip symptoms and difficulties during the last week.

Symptoms

0 - never, 1 - rarely, 2 - sometimes, 3 - often, 4 - always

S1. Do you feel grinding, hear clicking or any other type of noise from your hip? *

S2. Difficulties spreading legs wide apart *

S3. Difficulties to stride out when walking *

Pain

0 - never, 1 - monthly, 2 - weekly, 3 - daily, 4 - always

P1. How often is your hip painful? *

P2. Straightening your hip fully *

P3. Bending your hip fully *

P4. Walking on a flat surface *

P5. Going up or down stairs *

P6. At night while in bed *

P7. Sitting or lying *

P8. Standing upright *

P9. Walking on a hard surface (asphalt, concrete, etc.) *

P10. Walking on an uneven surface *

Function, sports and recreational activities

0 - none, 1 - mild, 2 - moderate, 3 - severe, 4 - extreme

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.

F1. Squatting *