Shoulder
Shoulder instability
Shoulder instability is measured with instability-specific scores rather than general shoulder scores, because a patient between dislocations may have a near-normal general score while remaining functionally unstable.
What you are actually deciding
General shoulder scores such as the SPADI or Simple Shoulder Test are poorly suited here — they measure pain and reach, not apprehension. Use an instability-specific instrument and record the number and mechanism of dislocations alongside it.
Patient-reported outcome measure5
- ASES Score11 itemsAmerican Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form — patient self-report sectionThe ASES score is a patient-reported shoulder index running from 0 to 100 in which a single 0–10 pain rating supplies 50 points and ten activities of daily living rated 0–3 supply the other 50, so that 100 represents a pain-free shoulder with no functional difficulty.
- KJOC Calculator10 itemsKerlan-Jobe Orthopaedic Clinic Shoulder and Elbow ScoreThe KJOC Shoulder and Elbow Score is a 10-item patient-reported questionnaire for overhead athletes — throwers, tennis players, swimmers — in which each item is rated 0 to 10 and the sum out of 100 describes how well the arm lets them compete, with a higher score meaning better function.
- QuickDASH Calculator11 itemsQuick Disabilities of the Arm, Shoulder and HandThe QuickDASH is an 11-item shortened form of the DASH that measures physical function and symptoms across the whole upper limb on a single 0 to 100 scale, where a higher score means greater disability.
- SST Calculator12 itemsSimple Shoulder TestThe Simple Shoulder Test asks twelve yes-or-no questions about everyday shoulder functions and scores the number answered yes, giving a total from 0 to 12 where 12 means all twelve functions are retained.
- WOSI Calculator21 itemsWestern Ontario Shoulder Instability IndexThe Western Ontario Shoulder Instability Index is a 21-item patient-reported measure of the quality-of-life effects of shoulder instability, each item rated 0 to 100 across four domains — physical symptoms, sports and work, lifestyle and emotions — and usually reported as a percentage of normal in which 100% means no impairment.
Clinical calculator2
- Constant Score Calculator10 itemsConstant-Murley Shoulder ScoreThe Constant-Murley score is a 100-point clinician-administered shoulder assessment combining 35 subjective points for pain and daily activities with 65 objective points for measured range of motion and abduction strength, where 100 represents a normal, pain-free shoulder.
- Rowe Score Calculator3 itemsRowe Score for Shoulder InstabilityThe Rowe score is a 100-point clinician-administered rating for shoulder instability that awards 50 points for stability, 20 for range of motion and 30 for function, where 100 represents a stable, fully mobile and unrestricted shoulder.
Thresholds that apply here
Published change thresholds across the instruments above. Check the population matches your patient before using a value — a threshold derived in a different cohort will mislead you.
| Instrument | Type | Value | Subscale | Population |
|---|---|---|---|---|
| ASES Score | MCID | 6.4 points | — | Patients with shoulder pain of mixed cause receiving outpatient physical therapy |
| ASES Score | MCID | 12.0 to 17.0 points | — | Rotator cuff disease treated nonoperatively |
| Constant Score | MCID | 10.4 points | — | Patients undergoing rotator cuff surgery |
| QuickDASH | MCID | 8 points | — | Upper limb musculoskeletal disorders |
| QuickDASH | MDC | 11.2 points | — | Upper limb musculoskeletal disorders |
| QuickDASH | MCID | 15.91 points | — | Shoulder pain, physiotherapy |
| QuickDASH | MCID | ~14 points | — | Rotator cuff repair |
| SST | MCID | 2 points | — | Rotator cuff disease and shoulder arthroplasty |
| SST | MCID | 2.05 points | — | Total shoulder arthroplasty |
| SST | SCB | 4.1 points | — | Total shoulder arthroplasty |
| SST | MDC | 2.8 points | — | Rotator cuff disease |
See the full threshold database for every instrument on the site.