Symptoms These questions should be answered considering your hip and/or groin symptoms and difficulties during the past week
1. Do you feel grinding, hear clicking or any other type of noise from your hip?
2. Difficulties spreading legs wide apart
3. 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
4. How severe is your hip joint stiffness after first wakening in the morning?
5. How severe is your hip stiffness arfter sitting, lying or resting later in the day?
Pain
6. How often is your hip painful?
What amount of hip pain have you experienced the last week during the following activities?
7. Straightening your hip fully
8. Bending your hip fully
9. Walking on flat surface
10. Going up or down stairs
11. At night while in bed
12. Sitting or lying
13. Standing upright
14. Walking on a hard surface (asphalt, concrete, etc.)
15. Walking on an uneven surface
Physical 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
16. Descending stairs
17. Ascending stairs
18. Rising from sitting
19. Standing
20. Bending to floor/puck up an object
21. Walking on flat surface
22. Getting in/out of car
23. Going shopping
24. Putting on socks/stockings
25. Rising from bed
26. Taking off socks/stockings
27. Lying in bed (turning over, maintaining hip position)
28. Getting in/out of bath
29. Sitting
30. Getting on/off toilet
31. Geavy domestic duties (moving heavy boxes, scrubbing floors, etc)
32. 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.
33. Squatting
34. Running
35. Twisting/pivoting on your injured hip
36. Walking on uneven surface
Quality of Life
37. How often are you aware of your hip problem?
38. Have you modifired your life style to avoid potentially damaging actvities to your hip?
39. How old are you troubled with lack of confidence in your hip?
40. In general, how much difficulty do you have with your hip?
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