PatientIQ Patient Portal

Note: A score of 100 (to the RIGHT) indicates an excellent functional state.

Overall, how much pain do you have in your hip/groin?Extreme painNo pain at all

How difficult is it for you to get up and down off the floor/ground?Extremely difficultNot difficult at all

How difficult is it for you to walk long distances?Extremely difficultNot difficult at all

How much trouble do you have with grinding, catching or clicking in your hip?Severe troubleNo trouble at all

How much trouble do you have pushing, pulling, lifting or carrying heavy objects?Severe troubleNo trouble at all

How concerned are you about cutting/changing directions during your sport or recreational activities?Extremely concernedNot concerned at all

How much pain do you experience in your hip after activity?Extreme painNo pain at all

How concerned are you about picking up or carrying children because of your hip?Extremely concernedNot concerned at all

Are you sexually active?

Yes

How much trouble do you have with sexual activity because of your hip?Severe troubleNo trouble at all

How much of the time are you aware of the disability in your hip?Constantly awareNot aware at all

How concerned are you about your ability to maintain your desired fitness level?Extremely concernedNot concerned at all

How much of a distraction is your hip problem?Extreme distractionNo distraction at all