Clinical calculator
UCLA Shoulder Score Calculator
University of California at Los Angeles Shoulder Rating Scale
The UCLA Shoulder Rating Scale is a 35-point shoulder assessment scoring pain and function out of 10 each, active forward flexion and forward-flexion strength out of 5 each, and patient satisfaction as either 0 or 5, where a higher total is better and 34–35 is graded excellent.
What the UCLA Shoulder Score means
UCLA Shoulder Score scores run from 2 to 35, where a higher score is better. The bands below are conventional reporting categories, not diagnostic cut-offs.
- Poor2–20
The four grades are Ellman’s. Because the pain and function items are scored from 1, the lowest attainable total is 2, not 0. Results are also commonly collapsed to satisfactory (28–35) versus unsatisfactory (2–27).
- Fair21–27
- Good28–33
- Excellent34–35
How the score is calculated
Stated in full so the calculation can be independently checked, and reproduced by hand if needed.
The five components are scored independently and added. Pain is scored 1, 2, 4, 6, 8 or 10 (1 constant and unbearable, 10 none). Function is scored on the same 1–10 values (1 unable to use the limb, 10 normal activities). Active forward flexion is scored 0–5 by measured arc (less than 30° = 0, 30–45° = 1, 45–90° = 2, 90–120° = 3, 120–150° = 4, 150° or more = 5). Strength of forward flexion is scored 0–5, the point value equalling the manual muscle test grade. Patient satisfaction is scored 5 if the patient is satisfied and better and 0 if not, with no intermediate value. The maximum is 35 and a higher total is better. Because pain and function are both scored from 1 rather than 0, the lowest attainable total is 2, not 0 — a calculator reporting a UCLA score of 0 or 1 has used a point value the scale does not contain. Totals are graded 34–35 excellent, 28–33 good, 21–27 fair and 2–20 poor; many series collapse these into satisfactory (28–35) and unsatisfactory (2–27).
Missing data
There is no imputation rule. All five components must be recorded for the total to be gradable, and a total reported with a component missing is not comparable with a complete score or with published series. Where forward-flexion strength cannot be tested because of pain, grade what the patient can actually produce rather than leaving the field blank.
Instrument profile
- Developer
- Harlan C. Amstutz and colleagues; the version in general use is the modification reported by Harvey Ellman and colleagues
- Institution
- University of California, Los Angeles, United States
- First published
- 1981
- Items
- 5
- Response format
- Five clinician-completed fixed-choice components, two of them rated by the patient
- Score range
- 2 to 35
- Direction
- Higher score = better
- Recall period
- Current status at the time of examination
- Completion time
- About 5 minutes
- Age range
- Adults
- Regions
- Shoulder
- Conditions
- Rotator cuff tear, Subacromial pain syndrome, Shoulder osteoarthritis, Adhesive capsulitis, Cuff tear arthropathy
- Procedures
- Rotator cuff repair, Subacromial decompression, Total shoulder arthroplasty, Reverse shoulder arthroplasty
- Languages
- English, Brazilian Portuguese, Turkish, Chinese, Persian, Spanish
- Observer agreement
- Not established for the scale as a whole in its original description; reliability data come from later translation and validation studies rather than from the developers.
- Validity
- Correlates with the Constant score, the ASES score and the SPADI in rotator cuff populations, and remains one of the most frequently reported outcomes in rotator cuff repair series, which is its principal practical value.
- Reliability
- Sensitive to change after rotator cuff repair and arthroplasty, but with only 35 points and five items the resolution is coarse — a single component shifting by one response step moves the grade.
- Ceiling effect
- Pronounced. The excellent band is only two points wide, so a large share of successfully treated shoulders clusters at 33–35 and further improvement cannot be detected.
- Floor effect
- Uncommon; the pain and function items are scored from 1, which lifts the attainable floor to 2.
Normative values
Reference values from published cohorts, for comparison against the score you calculated.
| Population | Age | Mean | SD |
|---|---|---|---|
| Shoulders after rotator cuff repair in the original modified-scale series, at final follow-up | — | Most shoulders reach the satisfactory range (28 or more); preoperative totals cluster in the poor and fair ranges | — |
When to use the UCLA Shoulder Score
Well suited to
- Reporting rotator cuff repair outcomes, where the scale is long established and comparison with the historical literature is the point.
- A quick clinician-administered rating when pain, a single plane of movement, strength and satisfaction are all that need recording.
- Serial follow-up by the same examiner, where forward flexion and manual muscle testing are performed the same way each time.
Limitations and poor fits
- Shoulder instability, where forward flexion and strength are usually normal and the scale cannot detect apprehension or recurrent dislocation — use the WOSI or the Rowe score.
- Distinguishing good outcomes from excellent ones, because of the two-point-wide excellent band and the strong ceiling effect.
- Postal or remote follow-up: two of the five components require examination, so the scale cannot be self-completed.
- Deciding whether an individual patient has improved meaningfully — no widely accepted minimal clinically important difference has been established for this scale, so a change of a few points cannot be interpreted against a published benchmark.
- Assessing conditions dominated by a rotational deficit, such as adhesive capsulitis or arthritis with an internal rotation contracture, which the forward-flexion-only motion item does not capture.
UCLA Shoulder Score compared with other instruments
Instruments measuring a related construct, with the practical difference between them.
| Instrument | Items | Range | What it adds |
|---|---|---|---|
| Constant Score | 10 | 0–100 | The 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. |
| ASES Score | 11 | 0–100 | The 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. |
| SPADI | 13 | 0–100 | The 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. |
| SST | 12 | 0–12 | The 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. |
| Oxford Shoulder Score | 12 | 0–48 | The Oxford Shoulder Score is a 12-item patient-reported questionnaire about shoulder pain and everyday function over the past four weeks, each item scored 0 to 4 and summed to a total of 0 to 48 in which 48 represents the best possible shoulder — it is licensed by Oxford University Innovation, so the item wording is not reproduced here. |
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.
A clinician-administered rating method rather than a proprietary questionnaire. Its five components and their point allocations were published in full in the peer-reviewed orthopaedic literature in 1981 and restated in the 1986 rotator cuff series, and are reproduced throughout the literature without a licensing programme. We have found no active rights holder charging for the method and have not sought written permission on that basis.
References
- Amstutz HC, Sew Hoy AL, Clarke IC. UCLA anatomic total shoulder arthroplasty. Clinical Orthopaedics and Related Research. 1981.
- Ellman H, Hanker G, Bayer M. Repair of the rotator cuff: end-result study of factors influencing reconstruction. Journal of Bone and Joint Surgery (American Volume). 1986.
- Kirkley A, Griffin S, Dainty K. Scoring systems for the functional assessment of the shoulder. Arthroscopy. 2003.
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.