Date of completion
Constant Shoulder Score
Clinician's name (or ref)
Patient's name (or ref)
Patient's d.o.b
 
Answer all questions, selecting just one unless otherwise stated
During the past 4 weeks......  
1. Pain   2. Activity Level (check all that apply)
Severe  
yes
no
Unaffected Sleep
Moderate  
yes
no
Full Recreation/Sport
Mild  
yes
no
Full Work
None      
         
3. Arm Positioning   4. Strength of Abduction [Pounds]
Up to Waist   0   13-15
Up to Xiphoid   1-3   15-18
Up to Neck   4-6   19-21
Up to Top of Head   7-9   22-24
Above Head   10-12   >24
RANGE OF MOTION  
5. Forward Flexion   6. Lateral Elevation
31-60 degrees   31-60 degrees
61-90 degrees   61-90 degrees
91-120 degrees   91-120 degrees
121-150 degrees   121-150 degrees
151-180 degrees   151-180 degrees
   
7. External Rotation   8. Internal Rotation
Hand behind Head, Elbow forward   Lateral Thigh
Hand behind Head, Elbow back   Buttock
Hand to top of Head, Elbow forward   Lumbosacral Junction
Hand to top of Head, Elbow back -   Waist (L3)
Full Elevation   T12 Vertebra
      Interscapular (T7)
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Constant Shoulder Score is

Grading the Constant Shoulder Score
(Difference between normal and Abnormal Side)

>30
 Poor
21-30
Fair
11-20
Good
<11
Excellent

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Fritz JM, George S. Identifying Psychosocial Variables in Patients With Acute Work-Related Low Back Pain: The Importance of Fear-Avoidance Beliefs. Phys Ther. 2002; 82(10): 973-983.

Lethem J, Slade PD, Troup JDG, Bendey G. Outline of a fear avoidance model of exaggerated pain perceptions, Behav Res Ther. 1983;21:401-408.

Williamson E. Fear Avoidance Behavior Questionnaire. Austrailian Journal of Physiotherapy. 2006; 52: 149.

Vlaeyen JWS, Kole-Snijders AMJ, Boeren RGB, van Eck H. Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain. 1995;62: 36, 272.