UCLA Shoulder Score

Evaluates clinical outcomes in patients who underwent total shoulder arthroplasty or suffer from rotator cuff pathology or instability.

Refer to the text below the score for more information about its usage, cut-off points and limitations.


The UCLA Shoulder Score was initially developed to assess clinical outcomes after total shoulder arthroplasty but has been used in a variety of other shoulder conditions (e.g. rotator cuff pathology or instability).

The score combines input from both the physician (items 2, 3 and 4) and the patient (items 1 and 5) and totals range from 0 to 35, 0s indicating worse shoulder function and 35s indicating better shoulder function outcomes.


UCLA Shoulder Score Interpretation

Scores range from 0 to 35, 0s indicating worse shoulder function and 35s indicating better shoulder function outcomes:

  • 27 Good/Excellent
  • <27 Fair/Poor

1

Section 1. Pain

2

Section 2. Function

3

Section 3. Active forward flexion

4

Section 4. Strength of forward flexion (manual muscle-testing)

5

Section 5. Satisfaction of patient

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UCLA Shoulder Score Explained

The University of California at Los Angeles (UCLA) Shoulder Score was initially developed to assess clinical outcomes of patients with shoulder arthritis undergoing total shoulder arthroplasty but has since then been used in a variety of other shoulder conditions (e.g. rotator cuff pathology or instability).

Section Answer choices and points
Section 1. Pain Present always and unbearable; strong medication frequently (1)
Present always but bearable' strong medication occasionally (2)
None or little at rest' present during light activities; salicylates used frequently (4)
Present during heavy or particular activities only; salicylates used occasionally (6) Occasional and slight (8)
None (10)
Section 2. Function Unable to use limb (1)
Only light activities possible (2)
Able to do light housework or most activities of daily living (4)
Most housework, shopping, and driving possible; able to do hair and to dress and undress, including fastening bra (6)
Slight restriction only; able to work above shoulder level (8)
Normal activities (10)
Section 3. Active forward flexion 150° (5)
120° - 150° (4)
90° - 120° (3)
45° - 90° (2)
30° - 45° (1)
<30° (0)
Section 4. Strength of forward flexion (manual muscle-testing) Grade 5 - normal (5)
Grade 4 - good (4)
Grade 3 - fair (3)
Grade 2 - poor (2)
Grade 1 - muscle contraction (1)
Grade 0 - nothing (0)
Section 5. Satisfaction of patient Satisfied and better (5)
Not satisfied and worse (0)

The score combines objective with subjective input from both the physician (items 2, 3 and 4) and the patient (items 1 and 5) and totals range from 0 to 35, 0s indicating worse shoulder function and 35s indicating better shoulder function outcomes.

There is also a cut-off at 27 points:

  • 27 Good/Excellent shoulder function;
  • <27 Fair/Poor shoulder function.

Some criticise the score because some items may be double-barrelled. For example, the pain domain combines frequency of pain and analgesia required, thus subjects may be facing difficulty choosing an appropriate answer if they agree with half of one answer for pain and half of another for analgesia.

Compared to other outcome measures, the UCLA shoulder score has shown poorer reliability, validity and responsiveness so further development and validation may be required.

 

References

Original reference

Amstutz HC, Sew Hoy AL, Clarke IC. UCLA anatomic total shoulder arthroplasty. Clin Orthop Relat Res. 1981; 155):7-20.

Validation

Wright RW, Baumgarten KM. Shoulder outcomes measures. J Am Acad Orthop Surg. 2010; 18(7):436-444.

Other references

Nutton RW, McBirnie JM, Phillips C. Treatment of chronic rotator-cuff impingement by arthroscopic subacromial decompression. J Bone Joint Surg Br. 1997; 79(1):73-76.

Smith MV, Calfee RP, Baumgarten KM, Brophy RH, Wright RW. Upper Extremity-Specific Measures of Disability and Outcomes in Orthopaedic Surgery. The Journal of Bone and Joint Surgery American volume. 2012; 94(3):277-285.

Kirkley A, Griffin S, Dainty K. Scoring systems for the functional assessment of the shoulder. Arthroscopy. 2003; 19(10):1109-1120.


Specialty: Orthopedics

System: Musculoskeletal

Year Of Study: 1981

Article By: Denise Nedea

Published On: July 6, 2020

Last Checked: July 6, 2020

Next Review: July 6, 2025