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Hip disability and Osteoarthritis Outcome Score
Symptoms - These questions should be answered thinking of your hip symptoms during the last week.
S1. Do you feel grinding, hear clicking or any other type of noise from you hip?
S2. Difficulties spreading legs wide apart
S3. 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.
S4. How severe is your hip joint stiffness after first wakening in the morning?
S5. How severe is your hip stiffness after sitting, lying or resting later in the day?
A. Symptoms, Stiffness Subtotal (sum of S1 through S5)
Symptoms,Stiffness % (sum of S1 through S5)/20, then multiply X100
Pain
P1. How often is your hip painful?
P2. Straightening your hip fully
P3. Bending your hip fully
P4. Walking on 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
B. Pain Subtotal (sum of P1 through P10)
Pain % (sum of P1 through P10)/40, then multiply X100
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.
Al. Descending stairs
A2. Ascending stairs
A3. Rising from sitting
A4. Standing
A5. Bending to floor/pick up an object
A6. Walking on flat surface
A7. Getting in/out of car
A8. Going shopping
A9. Putting on socks/stockings
A10. Rising from bed
A11. Taking off socks/stockings
A12. Lying in bed (turning over, maintaining hip position)
A13. Getting in/out of bath
A14. Sitting
A15. Getting on/off toilet
A16. Heavy domestic duties (moving heavy boxes, scrubbing floors, etc)
A17. Light domestic duties (cooking, dusting, etc)
C. Function, Daily Living Subtotal
Function, Daily Living % (sum of A1 through A17)/68, then multiply X100
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.
SP1. Squatting
SP2. Running
SP3. Twisting/pivoting on your injured knee
SP4. Walking on uneven surface
D. Function, Sports, Recreational Activities Subtotal (sum of SP1 through SP4)
Function, Sports, Recreational Activities % (sum of SP1 through SP4)/16, then multiply X100
Quality of Life
Q1. How often are you aware of your hip problem?
Q2. Have you modified your life style to avoid potentially damaging activities to 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?
E. Quality of Life Subtotal (sum of Q1 through Q5)
Quality of Life Subtotal (sum of Q1 through Q5)/16, then multiply X100
HOOS Score (sum of Subtotals A through E)
HOOS Total % (HOOS score /160)X100

DrChrono Physical Therapy | FOS Hip Disability and Osteoarthritis Outcome Score (HOOS) Medical Form

Physical Therapist

DrChrono's FOS hip disability and osteoarthritis outcome score form, customizable for your Physical Therapy practice.

There are 3 copies in use.
Published: Dec. 11, 2018, 6:14 p.m.
Doctor: Dr. History Physical
Rating: 0   /

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