Knee injury and Osteoarthritis Outcome Score (KOOS) – Physical Function Shortform (KOOS-PS) English version Today's Date MM DD YYYY Date of Birth MM DD YYYY Name First Name Last Name KOOS-Physical Function Shortform (KOOS-PS) INSTRUCTIONS: This survey asks for your view about your knee. This information will help us keep track of how well you are able to perform different activities. Answer every question by ticking the appropriate box, only one box for each question. If you are unsure about how to answer a question, please give the best answer you can so that you answer all the questions. The following questions concern your level of function in performing usual daily activities and higher level activities. For each of the following activities, please indicate the degree of difficulty you have experienced in the last week due to your knee problem. I promise to answer honestly to benefit my health and am ready to complete the questionnaire 1. Rising from bed None Mild Moderate Severe Extreme 2. Putting on socks/stockings None Mild Moderate Severe Extreme 3. Rising from sitting None Mild Moderate Severe Extreme 4. Bending to the floor None Mild Moderate Severe Extreme 5. Twisting/pivoting on your injured knee None Mild Moderate Severe Extreme 6. Kneeling None Mild Moderate Severe Extreme 7. Squatting None Mild Moderate Severe Extreme Thank you!
