• Name*full name
    0
  • Email*a valid email address
    1
  • *NeverMonthlyWeeklyDailyAlways
    How often is your knee painful?
    2
  • What degree of pain have you experienced the last week when…?*NoneMildModerateSevereExtreme
    P2 Twisting/pivoting on your knee
    P3 Straightening knee fully
    P4 Bending knee fully
    P5 Walking on flat surface
    P6 Going up or down stairs
    P7 At night while in bed
    P8 Sitting or lying
    P9 Standing upright
    3
  • Symptoms*NoneMildModerateSevereExtreme
    Sy1 How severe is your knee stiffness after first wakening in the morning?
    Sy2 How severe is your knee stiffness after sitting, lying, or resting later in the day?
    Sy3 Do you have swelling in your knee?
    Sy4 Do you feel grinding, hear clicking or any other type of noise when your knee moves?
    Sy5 Does your knee catch or hang up when moving?
    Sy6 Can you straighten your knee fully?
    Sy7 Can you bend your knee fully?
    4
  • What difficulty have you experienced the last week…?*NoneMildModerateSevereExtreme
    A1 Descending
    A2 Ascending stairs
    A3 Rising from sitting
    A4 Standing
    A5 Bending to floor/picking up an object
    A6 Walking on flat surface
    A7 Getting in/out of car
    A8 Going shopping
    A9 Putting on socks/stockings
    A10 Rising from bed
    A11 Taking off socks/stockings
    A12 Lying in bed (turning over, maintaining knee position)
    A13 Getting in/out of bath
    A14 Sitting
    A15 Getting on/off toilet
    A16 Heavy domestic duties (shovelling, scrubbing floors, etc)
    A17 Light domestic duties (cooking, dusting, etc)
    5
  • What difficulty have you experienced the last week…?*NoneMildModerateSevereExtreme
    Sp1 Squatting
    Sp2 Running
    Sp3 Jumping
    Sp4 Turning/twisting on your injured knee
    Sp5 Kneeling
    6
  • Knee-related quality of life*NeverMonthlyWeeklyDailyAlways
    Q1 How often are you aware of your knee problems?
    7
  • *Not at allMildlyModeratelySeverelyTotally
    Q2 Have you modified your lifestyle to avoid potentially damaging activities to your knee?
    How troubled are you with lack of confidence in your knee?
    8
  • *NoneMildModerateSevereExtreme
    Q4 In general, how much difficulty do you have with your knee?
    9
  • 10