| Variables | Aucune | Point (100) |
| Pain (45 points) | No | 45 |
| Average | 30 | |
| Moderate | 15 | |
| Severe | 0 | |
| Mobility (20 points) | 100 degree Arc | 20 |
| Arc 50 à 100˚ | 15 | |
| 2 degree Arc | 5 | |
| Stability (10 points) | Stable | 10 |
| Moderate instability | 5 | |
| Great instability | 0 | |
| Function (25 points) | Comb the hair | 5 |
| Eat alone | 5 | |
| Personal hygiene | 5 | |
| Put on a shirt | 5 | |
| Put on the shoes | 5 | |
| Score Total |
|
|
| Excellent: 90 - 100 |
|
|
| Good: 75 - 89 |
|
|
| Medium: 60 - 74 |
|
|
| Bad: 0 - 59 |
|
|