Constant and Murley developed a scoring system to quantitate the functionality of the shoulder. Each shoulder is evaluated separately. The score can be used to monitor a shoulder over time and to assess the effectiveness of interventions. The score was developed at Addenbrooke's Hospital at Cambridge, England.
Parameters in score (100 points maximum):
(1) pain (maximum 15 points)
(2) activities of daily living (ADL) (maximum 20 points)
(2a) positioning of hand (maximum 10 points)
(2b) full work (maximum 4 points)
(2c) full recreation and sport (maximum 4 points)
(2d) sleep unaffected (maximum 2 points)
(3) range of motion (maximum 40 points)
(3a) flexion (elevation in frontal plane) (maximum 10 points)
(3b) abduction (elevation in lateral plane) (maximum 10 points)
(3c) internal rotation (maximum 10 points)
(3d) external rotation (maximum 10 points)
(4) power (maximum 25 points)
|
Parameter |
Finding |
Points |
|---|---|---|
|
pain |
none |
15 |
|
|
mild |
10 |
|
|
moderate |
5 |
|
|
severe |
0 |
|
positioning of hand (ADL) |
above head |
10 |
|
|
up to top of head |
8 |
|
|
up to neck |
6 |
|
|
up to xyphoid |
4 |
|
|
up to waist |
2 |
|
|
unable to lift to waist level |
0 |
|
elevation in forward plane (range) |
151 – 180° |
10 |
|
|
121 – 150° |
8 |
|
|
91 – 120° |
6 |
|
|
61 – 90° |
4 |
|
|
31 – 60° |
2 |
|
|
0 – 30° |
0 |
|
elevation in lateral plane (range) |
151 – 180° |
10 |
|
|
121 – 150° |
8 |
|
|
91 – 120° |
6 |
|
|
61 – 90° |
4 |
|
|
31 – 60° |
2 |
|
|
0 – 30° |
0 |
|
internal rotation (range) |
dorsum of hand to interscapular region |
10 |
|
|
dorsum of hand to 12th dorsal vertebra |
8 |
|
|
dorsum of hand to waist (level of 3rd lumbar vertebra) |
6 |
|
|
dorsum of hand to lumbosacral junction |
4 |
|
|
dorsum of hand to buttock |
2 |
|
|
dorsum of hand to lateral thigh |
0 |
|
Activity of Daily Life |
Finding |
Points |
|---|---|---|
|
able to do full work (ADL) |
yes |
4 |
|
|
no |
0 |
|
able to do full recreation and sport (ADL) |
yes |
4 |
|
|
no |
0 |
|
sleep unaffected (ADL) |
yes |
2 |
|
|
no |
0 |
|
External Rotation |
Finding |
Points |
|---|---|---|
|
hand behind head with elbow held forward |
yes |
2 |
|
|
no |
0 |
|
hand behind head with elbow held back |
yes |
2 |
|
|
no |
0 |
|
hand on top of head with elbow held forward |
yes |
2 |
|
|
no |
0 |
|
hand on top of head with elbow held back |
yes |
2 |
|
|
no |
0 |
|
full elevation from top of head |
yes |
2 |
|
|
no |
0 |
power points =
= ((pounds held at 90°, up to 25 lbs) / 25) * 25 =
= (pounds held at 90°, up to 25 lbs)
where:
• Power is scored based on the number of pounds of pull that the patient can resist in abduction, up to a maximum of 90°.
• A normal should in a 25 year old man can resist 25 pounds without difficulty and is awarded 25 points.
• The ability to lift a lesser weight is awarded proportionately fewer points.
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 100
• The higher the score, the better the shoulder functionality.
Specialty: Surgery, orthopedic
