I PAIN (30 Points)

None

30

Tenderness or minimal pain in sports or heavy labor

25

Minimal pain in ADL

20

15

Moderate and tolerable pain (Analgetic needed, occasional night pain)

10

Severe pain (ADL limited, frequent night pain)

5

Totally incapacitated because of pain

0

II FUNCTION (20 Points)

Strength in Abduction (5 Points)

Endurance (5 Points)

(To be measured at 90 degrees of abduction or

at possible abduction level.)

Normal

5

(Time in seconds of

holding 1 kg dumb-bell horizontally with

elbow extended and

force arm pronated)

More than 10 seconds

5

Excellent

4

More than 3 seconds

3

Good

3

More than 2 seconds

1

Fair

2

Zero

0

Poor

1

Zero

0

Activities of Daily Living (10 Points)

Combing hair

1

Reaching opposite axilla

1

Making knot in back

1

Open and close sliding door

1

Reaching mouth

1

Reaching overhead shelf

1

Sleep on involved side

1

Self hygienic care

1

Reaching side pocket(jacket)

1

Wearing jacket

1

Subtract one point from above for each activity that cannot be carried out, specify;

1. 2. 3.

III RANGE OF MOTION (30 Points)

Elevation (15 Points)

Exertal Rotation (9 Points)

Internal Rotation (6 Points)

More than 150 degrees

15

More than 60 degrees 9

Above T12 spinous process

6

More than 120 degrees

12

More than 30 degrees 6

Above L5 spinous process

4

More than 90 degrees

9

More than 0 degrees 3

Gluteal

2

More than 60 degrees

6

More than −20 degrees 2

Below gluteal

0

More than 30 degrees

3

Less than −20 degrees 0

0 degree

0

IV ROENTGENOGRAPHIC EVALUATION (5 Points)

Normal

5

Moderate changes or subluxation

3

Advanced change or dislocation

0

V JOINT STABILITY (15 Points)

Normal

15

Slight instability or apprehension

10

Severe instability or history or state of subluxation

5

Relevant history or state of dislocation

0