WOMAC Hip Index Y Y P. Socrates List of Scores
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1 HIP GENERAL CORE CAN urgeon AQOL4D * coming soon y Y P HAGO Hip and Groin Outcome core Y Y P Hamstrings core Y P HOO Hip Dysfunction and Osteoarthritis Outcome core Y Y P HO Hip Outcome core Y Y P IHOT 12 (replaces MHOT 14) Y Y P IHOT 33 (replaces MHOT 33) Y Y P Lower Extremity Functionality cale Y Y P Modified Harris Hip core Y Y P Non Arthritic Hip core Y Y P Oxford Hip core Y Y P Pain and Normal Visual Analogue core Y Y P Patient atisfaction, Normal, and Pain VA Postop Y Y P Patient atisfaction, Normal, and Pain VA Preop Y Y P Patient Work & port & History PreOp Y P Patient Work & port PostOp Y Y P OMO U Military Patient History Y Y P UCLA Activity Y P VAIL Hip core Y Y P VA Pain core Y Y P Veteran Rand 12 General Health urvey Y Y P Veteran Rand 36 General Health urvey Y Y P WOMAC Hip Index Y Y P LEGEND Y: these forms are available in the format of the column heading. can forms: forms available as a scannable PDF to capture data via a canner urg: P indicates the patient completes the form; is a surgeon completed form; C is combined ocrates List of cores
2 HIP ARTHROPLATY CORE CAN urgeon Ceramic Hip Noise core Y P Complications Y High Activity Arthroplasty core (HAA) Y Y P Hip PostOp Examination HOO Hip Dysfunction and Osteoarthritis Outcome core Y Y P Oxford Hip core Y Y P Pain and Normal Visual Analogue core Y Y P Preop Examination OMO U Military Patient History Y Y P UCLA Activity Y P VA Pain core Y Y P Veteran Rand 12 General Health urvey Y Y P
3 KNEE GENERAL CORE CAN urgeon ACL Knee Postop Y Y P ACL Knee Preop Y Y P Brittberg Y P Chondropenia core Hamstrings core Y P IKDC Paediatric Y Y P IKDC Patient Y Y P IKDC urgeon Knee Arthroscopy urgery Details Y Knee ociety core (K) Y Y P Knee ociety core V * coming soon Y Y P Knee ymptoms Exam PostOp Knee ymptoms Exam PreOp KOO Knee Injury and Osteoarthritis Outcome core Y Y P Lower Extremity Functionality cale Y Y P Marx Y Y P Mocart Grading & core cale Modified Cincinnati Knee core Y Y P Patient Demographics and urgery Details Veteran Rand 12 General Health urvey Y Y P Veteran Rand 36 General Health urvey Y Y P VIA Knee core y y P WOMAC Knee Y Y P
4 KNEE ARTHROPLATY CORE CAN urgeon Complications Y High Activity Arthroplasty core (HAA) Y Y P Knee ociety core (K) Y Y P Knee ociety core V * coming soon Y Y P KOO Knee Injury and Osteoarthritis Outcome core Y Y P Kujala Y Y P Oxford Knee core Y Y P Pain and Normal Visual Analogue core Y Y P OMO U Military Patient History Y Y P UCLA Activity Y P VA Pain Y Y P Veteran Rand 12 General Health urvey Y Y P
5 HOULDER CORE CAN urgeon AE Rating cale Patient Y Y C AE Rating cale urgeon Y Complications Y Constant core Y Y C DAH Disabilities of the Arm, houlder and Hand core Y Y P DAH Quick Y Y P Flex 36 houlder rating Y P L'insalata Y Y P MI Melbourne houlder core Y Y P Oxford Instability core Y Y P Oxford houlder core Y Y P Patient History Work & port PreOp Y P Patient atisfaction, Normal, and Pain VA Postop Y Y P Patient atisfaction, Normal, and Pain VA Preop Y Y P Patient Work & port PostOp Y Y P PENN houlder core Y Y P ROWE houlder core Y ane (Normal) Pain Visual Analogue core Y Y P houlder Activity Level (Current) Y Y P houlder Activity Level (Preinjury) Y Y P houlder Instability Rating Y imple houlder Test (T) Y Y P WOO Western Ontario Arthritis of the houlder Index Y Y P WORC Western Ontario Rotator Cuff Index Y Y P WOI Western Ontario houlder Instability Index Y Y P
6 GENERAL CORE CAN urgeon Complications Y Pain and Normal Visual Analogue core Y Y P Patient Demographics and urgery Details Patient History Work & port PreOp Y Y P Patient atisfaction, Normal, and Pain VA Postop Y Y P Patient atisfaction, Normal, and Pain VA Preop Y Y P Patient Work & port PostOp Y Y P OMO U Military Patient History Y Y P VA Pain Y Y P Veteran Rand 12 General Health urvey Y P Veteran Rand 36 General Health urvey Y P
7 ELBOW & HAND CORE CAN urgeon AE American houlder and Elbow ociety core Y Y B Complications Y DAH Disabilities of the Arm, houlder and Hand core Y Y P DAH Quick Y Y P Mayo Elbow Y Y C Mayo Wrist Y Y C Pain and Normal Visual Analogue core Y Y P Patient History Work & port PreOp Y Y P Patient atisfaction, Normal, and Pain VA Postop Y Y P Patient atisfaction, Normal, and Pain VA Preop Y Y P Patient Work & port PostOp Y Y P PREE Patient Rated Elbow Evaluation Y Y P PRWE Patient Rated Wrist Evaluation Y Y P houlder Activity Level Y Y P OMO U Military Patient History Y Y P VA Pain Y Y P Veteran Rand 12 General Health urvey Y Y P Veteran Rand 36 General Health urvey Y Y P
8 FOOT & ANKLE CORE CAN urgeon AFA American Foot and Ankle cale Y P Ankle Osteoarthritis cale y y P Complications Y GROC Global Rating of Change Y P Marx Activity core Y Y P MOX Foot Y y P Oxford Ankle Foot Questionnaire Parent Y Y P Pain and Normal Visual Analogue core Y y P Patient History Work & port PreOp Y Y P Patient atisfaction, Normal, and Pain VA Preop Y Y P Patient Work & port PostOp Y Y P OMO U Military Patient History Y Y P Tegner Activity core Y P UCLA Activity Y P VA Pain Y Y P Veteran Rand 12 General Health urvey Y Y P Veteran Rand 36 General Health urvey Y Y P VIA A Achilles tendon questionnaire y y P
9 PINE CORE CAN urgeon Back & Leg Patient urvey PostOp Y P Back & Leg Patient urvey PreOp Y P Complications Y DRAM Distress & Risk Assessment Y Y P Japanese Orthopaedic Association Back Pain Evaluation Y Y P Japanese Orthopaedic Association Cervical Myelopathy Evaluation Y Y P Military pecific Patient History Y P Modified Low Back Pain Disability Questionnaire y y P Neck & Arm Patient urvey PostOp Y P Neck & Arm Patient urvey PreOp Y P Neurogenic Claudication Outcome y Y P ODI Oswestry Disability Index Y Y P ODOM Back Y Y P ODOM Neck Y Y P Pain and Normal Visual Analogue core Y Y P Patient atisfaction, Normal, and Pain VA Preop Y P Revised Disability Index for Low Back Pain/Dysfunction y y P Roland Morris Back Pain and Disability core Y Y P OMO U Military Patient History Y Y P pine Combined LITE POTOP Y P pine Combined LITE PREOP Y P pine Medical History Y P Tampa cale for Kinesiophobia Y Y P VA Back & Leg Y Y P VA Neck & Arm Y Y P Vernon Moir Neck Disability Index Y Y P Veteran Rand 12 General Health urvey Y Y P Veteran Rand 36 General Health urvey Y Y P Zurich Claudication Questionnaire Y Y P
Forms list... 2 Examples of a few form layouts Scannable Forms... 13
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