Stride Sculpture | HOOS HIP SURVEY

17409

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HOOS HIP SURVEY

Your Name (required)

Your Email (required)

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

Do you feel grinding, hear clicking or any type of noise when your hip moves?

Difficulties spreading your legs wide apart?

Difficulties to stride out when walking?

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.

How severe is your hip joint stiffness after first waking up in the morning?

How severe is your hip stiffness after sitting, lying or resting later in the day?

Pain

How often is your hip painful?

Straightening your hip fully?

Bending your hip fully?

Straightening your hip fully?

Walking on a flat surface?

Going up or down stairs?

At night in bed?

Sitting or lying?

Standing upright?

Walking on a hard surface (tarmac, concrete, etc.)?

Walking on an uneven surface?

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:

Descending stairs?

Ascending stairs?

Rising from sitting?

Standing

Bending to floor/pick up an object?

Walking on a flat surface?

Getting in/out of a car?

Going shopping?

Putting on socks/tights?

Rising from bed?

Taking off socks/tights?

Lying in bed? (turning over, maintaining hip position)

Getting in/out of bath?

Sitting?

Getting on/off the toilet?

Heavy domestic duties? (moving heavy boxes, scrubbing floors etc.)

Light domestic duties? (cooking, dusting etc.)

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 hip:

Squatting?

Running?

Jumping?

Twisting/Pivoting on loaded leg?

Walking on uneven surface?

Quality of Life

How often are you aware of your hip problem?

Have you modified your lifestyle to avoid potentially damaging activities to your hip?

How much are you troubled with your lack of confidence in your hip?

In general, how much difficulty do you have with your hip?