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OrthoMeasure

Patient-reported outcome measure

KJOC Calculator

Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score

The 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.

Licence unconfirmed10 items~3 min0–100, higher is better

Your arm in competition

Rate each item from 0 to 10, where 10 is no problem at all and 0 is the worst possible. The best response for each item is shown under the question.

10 = no difficulty; 0 = the worst.

of 10

10 = no pain; 0 = the worst.

of 10

10 = no weakness or fatigue; 0 = the worst.

of 10

10 = not unstable; 0 = the worst.

of 10

10 = not at all; 0 = the worst.

of 10

10 = no change; 0 = the worst.

of 10

10 = not at all; 0 = the worst.

of 10

10 = no limitation; 0 = the worst.

of 10

10 = not at all; 0 = the worst.

of 10

10 = not at all; 0 = the worst.

of 10

What the KJOC score means

KJOC totals run from 0 to 100, where a higher score is better. No severity bands are shown because no cut-offs have been published that we can verify — read the total against the source studies and your own protocol, as described below.

    How the score is calculated

    Stated in full so the calculation can be independently checked, and reproduced by hand if needed.

    Each of the ten questions asks about the shoulder or elbow in competition — getting loose, pain, weakness or fatigue, instability, effect on relationships with coaches and management, changes to throwing motion, velocity and power, endurance, control, and overall effect on level of competition. Each item is marked from 0 to 10, where 10 is no problem, and the ten are added to give a score out of 100. A higher score means better function. On the published form each item is marked on a 100 mm line and the ten are averaged, which gives the same figure. No severity bands are shown because we could not verify published ones.

    Missing data

    No missing-data rule has been published, so a score is shown only when all ten items are answered.

    Instrument profile

    Developer
    Frank G. Alberta, Neal S. ElAttrache and colleagues
    Institution
    Kerlan-Jobe Orthopaedic Clinic, Los Angeles, United States
    First published
    2010
    Custodian
    Kerlan-Jobe Orthopaedic Clinic
    Items
    10
    Response format
    Visual analogue scale, 0 to 10 per item
    Score range
    0 to 100
    Direction
    Higher score = better
    Recall period
    Current status in competition or practice
    Completion time
    About 3 minutes
    Age range
    Overhead athletes
    Regions
    Shoulder, Elbow
    Conditions
    Shoulder instability, Rotator cuff disease, Ulnar collateral ligament injury, Overhead athlete shoulder injury
    Procedures
    Ulnar collateral ligament reconstruction, Shoulder stabilisation, SLAP repair, Rotator cuff repair
    Languages
    English, Persian, Turkish, Finnish
    Internal consistency
    High in validation studies in other languages (for example a Cronbach’s alpha of 0.92 in a Finnish version and 0.947 in a Persian version); not re-checked against the original development paper.
    Validity
    Developed for overhead athletes, whose arm demands are not captured by general shoulder scores, and since used in baseball, softball and other throwing and racquet sports.
    Responsiveness
    Used to follow return to competition after shoulder and elbow surgery. No minimal clinically important difference is shown here because we could not verify a published value.
    Ceiling effect
    A ceiling effect has been reported in asymptomatic athletes, who can score at or near the maximum on individual items.

    When to use the KJOC

    Well suited to

    • Overhead athletes — baseball and softball pitchers, tennis players, swimmers and other throwers — with shoulder or elbow problems.
    • Following return to competition after shoulder or elbow surgery in the same athletes, particularly alongside a general shoulder score.

    Limitations and poor fits

    • Non-athletes, or people whose arm problems do not involve throwing or racquet sport: use the SPADI, ASES or QuickDASH.
    • Shoulder instability in a general population, where the WOSI is the disease-specific measure.
    • Judging whether an individual athlete has improved meaningfully: no minimal clinically important difference is shown here.

    KJOC compared with other instruments

    Instruments measuring a related construct, with the practical difference between them.

    InstrumentItemsRangeWhat it adds
    WOSI210–100The 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.
    ASES Score110–100The 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.
    SPADI130–100The SPADI is a 13-item patient-reported questionnaire that measures shoulder pain and disability over the past week on two subscales — 5 pain items and 8 disability items — each rated 0–10 and transformed to a 0–100% score in which a higher score means more pain and greater disability.
    QuickDASH110–100The 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.
    Mayo Elbow Score80–100The Mayo Elbow Performance Score is a 100-point examiner-completed rating of the elbow that combines 45 points for pain, 20 for arc of motion, 10 for stability and 25 for five daily tasks, graded excellent at 90 or above, good at 75 to 89, fair at 60 to 74 and poor below 60.

    Copyright and permitted use

    Published openly because it is the question every clinician and researcher asks before using an instrument, and almost nobody answers it.

    Licence unconfirmedRights holder: Kerlan-Jobe Orthopaedic Clinic

    The questionnaire is reproduced in published validation studies and used widely in sports medicine, but its copyright holder has not been confirmed by us. We have not asked for written permission, so we cannot say it is free of copyright; if a rights holder objects, the item wording will be removed and the page reduced to a profile.

    References

    1. Alberta FG, ElAttrache NS, Bissell S, et al.. The development and validation of a functional assessment tool for the upper extremity in the overhead athlete. American Journal of Sports Medicine. 2010.

    Editorial status

    Not yet reviewedQueued for clinical review by Sam Tuffun, PT, DPT. Sign-off has not taken place — this is a placeholder assignment, not a completed review.