Constant Score: Out-Patient Clinic Shoulder Unit

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OUT-PATIENT CLINIC

SHOULDER UNIT

CONSTANT SCORE
Patients Details

Operation/Diagnosis: Examination: Pre-op 3 months 1 year

Date: Side: R 6months 2 years


L

___ years

A.- Pain (/15): Average (1 + 2)

A
Severe or permanent = 0.

1. Do you have pain in your shoulder (normal activities)? No =15 pts, Mild pain = 10 pts, Moderate = 5 pts,

2. Linear scale: If 0 means no pain and 15 is the maximum pain you can experience, please circle where is the level of pain of your shoulder. (Points given are inverse to the scale. E.g. level 5 in the scale means 10 points) Level of pain: 0 Points: 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

B.- Activities of daily living (/20)

Total (1 + 2 + 3 + 4) B 1. Is your occupation or daily living limited by your shoulder? No = 4, Moderate limitation = 2, Severe limitation = 0 2. Are your leisure and recreational activities limited by your shoulder? No = 4, Moderate limitation = 2, Severe limitation = 0 3. Is your night sleep disturbed by your shoulder? No = 2, Sometimes = 1, Yes = 0 4. State to what level you can use your arm for painless, reasonably activities. Waist = 2, Xiphoid (sternum) = 4, Neck = 6, Head = 8, Above head = 10 Total (1 + 2 + 3 + 4) 0 - 30 31 - 60 61 - 90 91 - 120 > 150 4.- Internal Rotation : (Dorsum hand to) Thigh 0 Buttock 2 SI joint 4 Waist 6 T12 8 Between shoulder blades 10

C.- Range of movement (leave this for the doctor or physiotherapist) (/40):
1.- FWD Flexion : 0 - 30 31 -60 61 - 90 91 - 120 121- 150 > 150 0 pts 2 pts 4 pts 6 pts 8 pts 10 pts 2.- Abduction:

121 - 150

3.- External Rotation: Hand behind head & elbow forward 2 Hand behind head & elbow back 4 Hand above head & elbow forward 6 Hand above head & elbow back 8 Full elevation of arm 10

D.- Power (/25): Points: average (kg) x 2 =


First pull: Second pull: Average pulls: Third pull:

D
Fourth pull: Fifth pull:

TOTAL (/100): A + B + C+ D

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