PatientIQ Patient Portal

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Koos

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Outstanding Tasks0

Complete Tasks Below
Click on the items below to complete.

Koos

KOOS

Form

KOOS
Form

KOOS

Symptoms

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

Stiffness

The following questions concern the amount of joint stiffness you have experienced during the last week in your knee. Stiffness is a sensation of restriction or slowness in the ease with which you move your knee joint.

Pain

KOOS Pain Matrix

What amount of knee pain have you experienced the last week during the following activities?

	None	Mild	Moderate	Severe	Extreme
Twisting/pivoting on your knee
Straightening knee fully
Bending knee fully
Walking on flat surface
Going up or down stairs
At night while in bed
Sitting or lying
Standing upright

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Function, daily living

The following questions concern your physical function. By this we mean your ability to move around and to look after yourself.

Function 1

For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee.

Function 2

For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee.

	None	Mild	Moderate	Severe	Extreme
Rising from sitting
Standing
Bending to floor/pick up an object
Walking on a flat surface
Getting in/out of car
Going shopping
Putting on socks/stockings
Rising from bed
Taking off socks/stockings
Lying in bed (turning over, maintaining knee position)
Getting in/out of bath
Sitting
Getting on/off toilet

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Function 3

For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee.

Function, sports and recreational activities

Sport 1

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 knee.

	None	Mild	Moderate	Severe	Extreme
Heavy domestic duties (moving heavy boxes, scrubbing floors, etc)
Light domestic duties (cooking, dusting, etc)

	None	Mild	Moderate	Severe	Extreme
Squatting
Running
Jumping
Twisting/pivoting on your injured knee
Kneeling

Koos

KOOS

KOOSForm

Koos

KOOS

KOOSForm

Symptoms

Stiffness

Pain

What amount of knee pain have you experienced the last week during the following activities?

Function, daily living

For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee.

For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee.

For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee.

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 knee.

Quality of Life

KOOS
Form

KOOS
Form