The Hospital for Special Surgery (HSS) Elbow Assessment Scale can be used to evaluate a person's elbow function. It can be used to monitor a person over time and to determine the effectiveness of a therapeutic intervention.
Parameters:
(1) pain: 2 measures (pain when bending, pain at rest)
(2) function and activities: 2 measures (bending activities, elbow use)
(3) muscle strength: 1 measure
(4) range of motion: 3 measures (sagittal arc, pronation, supination)
(5) deformity: 2 measures (flexion contracture, extension contracture)
|
Parameter |
Finding |
Points |
|
pain when bending |
none |
15 |
|
|
mild |
10 |
|
|
moderate |
5 |
|
|
severe |
0 |
|
pain at rest |
none |
15 |
|
|
mild |
10 |
|
|
moderate |
5 |
|
|
severe |
0 |
|
bending activities |
can do bending activities for 30 minutes |
8 |
|
|
can do bending activities for 15 minutes |
6 |
|
|
can do bending activities for 5 minutes |
4 |
|
|
cannot do bending activities |
0 |
|
use of elbow |
unlimited use |
12 |
|
|
limited only during recreation |
10 |
|
|
household and employment use |
8 |
|
|
limited to independent self-care |
6 |
|
|
cannot use elbow (invalid) |
0 |
|
sagittal arc |
degrees of motion |
1 point for each 7° |
|
muscle strength |
can lift 2.3 kg to 90° |
10 |
|
|
can lift 0.9 kg to 90° |
8 |
|
|
moves through arc of motion against gravity |
5 |
|
|
cannot move through arc of motion |
0 |
|
flexion contracture |
< 15° |
6 |
|
|
between 15 and 45° |
4 |
|
|
between 45° and 90° |
2 |
|
|
> 90° |
0 |
|
extension contracture |
> 125° (within 15° of 135°) |
6 |
|
|
100 - 124° (< 125°) |
4 |
|
|
80 - 99° (< 100°) |
2 |
|
|
< 80° |
0 |
|
pronation |
> 60° |
4 |
|
|
> 30 to 60° |
3 |
|
|
> 15 to 30° |
2 |
|
|
0 to 15° |
0 |
|
supination |
> 60° |
4 |
|
|
> 30 to 60° |
3 |
|
|
> 15 to 30° |
2 |
|
|
0 to 15° |
0 |
where:
• The maximum sagittal arc needs to be 140° to get 100 points as maximum HSS scale.
• Flexion contracture is interpreted as the number of degrees of flexion caused by the contracture.
• Extension contracture is interpreted as the angle achieved at maximum extension for the patient, which would be reduced by any contracture.
HSS elbow assessment scale =
= SUM(points for findings present)
Interpretation:
• minimum score: 0
• maximum score: 100
• The higher the score, the better the elbow function.
The change in score after an intervention can be used to determine its effectiveness.
|
Increase from Previous Score |
Assessment |
|
< 21 points |
failure |
|
21 - 30 |
satisfactory |
|
>= 31 |
good |
Specialty: Surgery, orthopedic
