PatientIQ Patient Portal

International Hip Outcome Tool (IHOT12)

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

Overall, how much pain do you have in your hip/groin?010000002468101214161820222426283032343638404244464850525456586062646668707274767880828486889092949698100Extreme painNo pain at all

How difficult is it for you to get up and down off the floor/ground?010000002468101214161820222426283032343638404244464850525456586062646668707274767880828486889092949698100Extremely difficultNot difficult at all

How difficult is it for you to walk long distances?010000002468101214161820222426283032343638404244464850525456586062646668707274767880828486889092949698100Extremely difficultNot difficult at all

How much trouble do you have with grinding, catching or clicking in your hip?010000002468101214161820222426283032343638404244464850525456586062646668707274767880828486889092949698100Severe troubleNo trouble at all

How much trouble do you have pushing, pulling, lifting or carrying heavy objects?010000002468101214161820222426283032343638404244464850525456586062646668707274767880828486889092949698100Severe troubleNo trouble at all

How concerned are you about cutting/changing directions during your sport or recreational activities?010000002468101214161820222426283032343638404244464850525456586062646668707274767880828486889092949698100Extremely concernedNot concerned at all

How much pain do you experience in your hip after activity?010000002468101214161820222426283032343638404244464850525456586062646668707274767880828486889092949698100Extreme painNo pain at all

How concerned are you about picking up or carrying children because of your hip?010000002468101214161820222426283032343638404244464850525456586062646668707274767880828486889092949698100Extremely concernedNot concerned at all

Are you sexually active?

Yes

How much of the time are you aware of the disability in your hip?010000002468101214161820222426283032343638404244464850525456586062646668707274767880828486889092949698100Constantly awareNot aware at all

How concerned are you about your ability to maintain your desired fitness level?010000002468101214161820222426283032343638404244464850525456586062646668707274767880828486889092949698100Extremely concernedNot concerned at all

How much of a distraction is your hip problem?010000002468101214161820222426283032343638404244464850525456586062646668707274767880828486889092949698100Extreme distractionNo distraction at all

Outstanding Tasks1

I Hot12 Test

iHOT12

iHOT12
Form

I Hot12 Test

iHOT12

iHOT12
Form

International Hip Outcome Tool (IHOT12)

I Hot12 Test

iHOT12

iHOT12Form

I Hot12 Test

iHOT12

iHOT12Form

International Hip Outcome Tool (IHOT12)

iHOT12
Form

iHOT12
Form