Measuring self-reported pain and function is a good way of monitoring patient progress and evaluating treatment efficacy. Below is a list of commonly used shoulder outcome questionnaires. The psychometric properties of each questionnaire have also been included to help select the questionnaire best suited to your purpose:
DASH (Disabilities of the Arm, Shoulder and Hand)
The DASH is one of the most widely-used, and most extensively tested outcome tools and is appropriate for patients with general upper limb dysfunction. It is not specific to a particular joint. It is also a good tool for capturing some health and quality of life factors. Online scoring is available.
Region: Entire upper limb
Items: 30
Subscores: Symptoms, function, work (optional), sport/arts (optional)
Recall period: 1 week
Scoring: Scoring the DASH (online scoring)
Scoring the QuickDASH (online scoring)
Scoring the QuickDASH (excel scoring tool)
Download Scoring Instruction Sheets
Minimal Detectable Change (95%) : DASH 7.9-14.8; QuickDASH 13.3
Minimal Clinically Important Difference: DASH 10.2; QuickDASH 8.0
About the DASH
Conditions of Use
SPADI (Shoulder Pain and Disability Index)
The SPADI is widely used in research, and in clinical practice. It demonstrates good responsiveness, good validity and is short and easy to complete.
Region: Shoulder
Items: 13
Subscores: Pain (5 items) and function (8 items)
Recall period: 1 week
Scoring: At least 3 of 5 pain and 6 of 8 function items for the subscales are necessary. The SPADI total score is the unweighted mean of the pain and function subscores. 0=best, 100=worst.
Minimal Detectable Change (95%) : 17-22
Minimal Clinically Important Difference: 13-23
Shoulder Pain and Disability Index link: https://www.tac.vic.gov.au/files-to-move/media/upload/spi.pdf
ASES (American Shoulder and Elbow Surgeons) Society Standardised Assessment Form
The ASES has a patient self-report section (pASES), and a clinical information section to be completed by the examiner (ASES-examiner ) however the examiner version is rarely used and the pASES can be used in isolation. This score has been reported to be reliable, valid and responsive. Online scoring is available.
Region: Shoulder
Items: pASES 18
Subscores: Pain (6 items), instability (2 items), ADLs (10 items)
Recall period: 1 week
Scoring: The pASES total score = ((10-VAS pain) x5) + (5/3 x sum of ADL items). The instability items and the remaining 5 pain items do not contribute to the pASES total score. Online scoring is recommended. 0=worst, 100=best.
ASES Online Scoring
Minimal Detectable Change (95%) : 11.2
Minimal Clinically Important Difference: 12-17
ASES Score (online scoring version)
Oxford Shoulder Score (OSS)
Intended for use post-operatively following shoulder surgery, except for stabilisation surgery). Psychometric information is still lacking for this questionnaire. Online scoring is available.
Region: Post-operative shoulder conditions (except for shoulder stabilisation surgery)
Items: 12
Subscores: Pain (4 items) and daily function (8 items)
Recall period: 4 weeks
Scoring: The (total) score is the sum of the (completed) 12 items (scoring 1–5): 12=best and 60=worst.
OSS Online Scoring
Minimal Detectable Change (95%): no published data
Minimal Clinically Important Difference: no published data
Please note: a license may be required for this questionnaire
Oxford Shoulder Score (online scoring)
WOSI (Western Ontario Shoulder Instability Index)
The WOSI evaluates the disease-specific quality of life of patients with symptomatic shoulder instability. It is widely used, however, some psychometric information is still lacking.
NOTE: This score primarily uses visual analogue scales (VAS) and can be time-consuming to measure/score. In addition, when printing, the lines may not be exactly 100mm in length, requiring additional score conversion. The online version of the questionnaire is recommended for scoring purposes.
Region: Shoulder instability (surgical or non-surgical)
Items: 21
Subscores: Pain (10), sports/recreation/work (4), lifestyle (4), emotions (3).
Recall period: 1 week
Scoring: Sum of 21 unweighted items (0=best and 100=worst). Online scoring is recommended.
WOSI Online Scoring
Minimal Detectable Change (95%): no published data
Minimal Clinically Important Difference: no published data
WOSI questionnaire (online scoring)
Oxford Shoulder Instability Score
The Oxford Instability Score evaluates the disease-specific quality of life in patients with shoulder instability.
Region: Shoulder instability (surgical or non-surgical).
Note: Not suitable for post-surgical patients until at least 6-months.
Items: 12
Subscores:
Recall period: Questions vary from 4 weeks to 6-months.
Scoring: Sum of scores. 0=worst, 48=best.
Online scoring tool
Please note: a license may be required for this questionnaire
Oxford Shoulder Instability Score (online scoring)
Reference:
Angst F, Schwyzer HK, Aeschlimann A, et al. Measures of adult shoulder function: Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and Its Short Version (QuickDASH), Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) Society Standardized Shoulder Assessment Form, Constant (Murley) Score (CS), Simple Shoulder Test (SST), Oxford Shoulder Score (OSS), Shoulder Disability Questionnaire. Arthritis Care Res. 2011;63(SUPPL. 11): S174-S88.
DASH (Disabilities of the Arm, Shoulder and Hand)
The DASH is one of the most widely-used, and most extensively tested outcome tools and is appropriate for patients with general upper limb dysfunction. It is not specific to a particular joint. It is also a good tool for capturing some health and quality of life factors. Online scoring is available.
Region: Entire upper limb
Items: 30
Subscores: Symptoms, function, work (optional), sport/arts (optional)
Recall period: 1 week
Scoring: Scoring the DASH (online scoring)
Scoring the QuickDASH (online scoring)
Scoring the QuickDASH (excel scoring tool)
Download Scoring Instruction Sheets
Minimal Detectable Change (95%) : DASH 7.9-14.8; QuickDASH 13.3
Minimal Clinically Important Difference: DASH 10.2; QuickDASH 8.0
About the DASH
Conditions of Use
SPADI (Shoulder Pain and Disability Index)
The SPADI is widely used in research, and in clinical practice. It demonstrates good responsiveness, good validity and is short and easy to complete.
Region: Shoulder
Items: 13
Subscores: Pain (5 items) and function (8 items)
Recall period: 1 week
Scoring: At least 3 of 5 pain and 6 of 8 function items for the subscales are necessary. The SPADI total score is the unweighted mean of the pain and function subscores. 0=best, 100=worst.
Minimal Detectable Change (95%) : 17-22
Minimal Clinically Important Difference: 13-23
Shoulder Pain and Disability Index link: https://www.tac.vic.gov.au/files-to-move/media/upload/spi.pdf
ASES (American Shoulder and Elbow Surgeons) Society Standardised Assessment Form
The ASES has a patient self-report section (pASES), and a clinical information section to be completed by the examiner (ASES-examiner ) however the examiner version is rarely used and the pASES can be used in isolation. This score has been reported to be reliable, valid and responsive. Online scoring is available.
Region: Shoulder
Items: pASES 18
Subscores: Pain (6 items), instability (2 items), ADLs (10 items)
Recall period: 1 week
Scoring: The pASES total score = ((10-VAS pain) x5) + (5/3 x sum of ADL items). The instability items and the remaining 5 pain items do not contribute to the pASES total score. Online scoring is recommended. 0=worst, 100=best.
ASES Online Scoring
Minimal Detectable Change (95%) : 11.2
Minimal Clinically Important Difference: 12-17
ASES Score (online scoring version)
Oxford Shoulder Score (OSS)
Intended for use post-operatively following shoulder surgery, except for stabilisation surgery). Psychometric information is still lacking for this questionnaire. Online scoring is available.
Region: Post-operative shoulder conditions (except for shoulder stabilisation surgery)
Items: 12
Subscores: Pain (4 items) and daily function (8 items)
Recall period: 4 weeks
Scoring: The (total) score is the sum of the (completed) 12 items (scoring 1–5): 12=best and 60=worst.
OSS Online Scoring
Minimal Detectable Change (95%): no published data
Minimal Clinically Important Difference: no published data
Please note: a license may be required for this questionnaire
Oxford Shoulder Score (online scoring)
WOSI (Western Ontario Shoulder Instability Index)
The WOSI evaluates the disease-specific quality of life of patients with symptomatic shoulder instability. It is widely used, however, some psychometric information is still lacking.
NOTE: This score primarily uses visual analogue scales (VAS) and can be time-consuming to measure/score. In addition, when printing, the lines may not be exactly 100mm in length, requiring additional score conversion. The online version of the questionnaire is recommended for scoring purposes.
Region: Shoulder instability (surgical or non-surgical)
Items: 21
Subscores: Pain (10), sports/recreation/work (4), lifestyle (4), emotions (3).
Recall period: 1 week
Scoring: Sum of 21 unweighted items (0=best and 100=worst). Online scoring is recommended.
WOSI Online Scoring
Minimal Detectable Change (95%): no published data
Minimal Clinically Important Difference: no published data
WOSI questionnaire (online scoring)
Oxford Shoulder Instability Score
The Oxford Instability Score evaluates the disease-specific quality of life in patients with shoulder instability.
Region: Shoulder instability (surgical or non-surgical).
Note: Not suitable for post-surgical patients until at least 6-months.
Items: 12
Subscores:
Recall period: Questions vary from 4 weeks to 6-months.
Scoring: Sum of scores. 0=worst, 48=best.
Online scoring tool
Please note: a license may be required for this questionnaire
Oxford Shoulder Instability Score (online scoring)
Reference:
Angst F, Schwyzer HK, Aeschlimann A, et al. Measures of adult shoulder function: Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and Its Short Version (QuickDASH), Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) Society Standardized Shoulder Assessment Form, Constant (Murley) Score (CS), Simple Shoulder Test (SST), Oxford Shoulder Score (OSS), Shoulder Disability Questionnaire. Arthritis Care Res. 2011;63(SUPPL. 11): S174-S88.
