Shoulder Disorders

sec_arr Appendix B

Validated Tools for Determining Shoulder Recovery

Various validating scores for shoulder recovery have been developed and although they greatly assist in determining patient recovery from shoulder injury or surgery, they all have shortcomings. The shoulder is a highly mobile joint and as previously discussed is also dependent upon mobility of the elbow and the wrist for full function. This has led to some scoring systems focusing on upper extremity function rather than the shoulder as an isolated joint.

  • DASH: A self-assessment score for multiple disorders of the upper extremities. It has 30 items that assess both symptoms and functions. It is not specific to the shoulder but measures the function of the upper extremity. A DASH score of <15 indicates no problems.
  • CONSTANT Score. Clinical examination and patient interview or self-assessment. This is often used for shoulder recovery. This test requires some specialized testing equipment for strength testing. This test has 4 domains: pain, mobility, ADLs, and strength. A CONSTANT score of 15 indicates normal function.
  • Oxford. General scoring systems for shoulder operations other than stabilization: 4 items about pain and 8 items about daily function. It is scored from 0 being the worst to 4 being the best.
  • Western Ontario Shoulder Instability (WOSI) Index. Used as a part of the assessment if shoulder instability is an issue. It is a self-assessment, containing 21 items in 4 domains: physical (including pain), sports/recreational/ work, lifestyle, emotions. The WOSI is scored from 0 (best) to 100 (worst).
  • Athletic Shoulder Outcome Rating Scale. Used in athletics with sport-specific shoulder demands. It is scored from 0-100 with scores from 90-100 indicating “excellent” outcome. Ninety percent (90%) of the scoring is subjective, with 10 points lost for each drop in self-reported athletic performance.25