Constant–Murley Score - OrthoToolKit version

Clinical intent

The Constant–Murley Score (CMS) was introduced as an instrument to evaluate overall shoulder function, irrespective of diagnosis [1]. After the approval and recommendation of the European Society for Surgery of the Shoulder and the Elbow, the CMS became a widely used tool. In 2008, modifications to the score have been suggested by Constant et al. [2]

The CMS asses two subjective aspects answered by the patient: pain and activities of daily living (ADL) and two objective aspects answered by the orthopedic surgeon or the physiotherapist: range of motion (ROM) and strength. The subjective components can receive up to 35 points and the objective 65, resulting in a possible maximum total score of 100 points (best function) [1,3].

OrthoToolKit version

Multiple versions of the Constant Murley Score are circulating. This calculation is based of the OrthoToolKit version and should therefore be used with the same form.

Link to English questionnaire of this version.

Calculation

Pain scale

The pain scale only has one item, a VAS slider ranging from 0 to 15 points, which directly represents the score for the pain scale.

ADL scale

The ADL scale has 4 items which are summed to get the ADL scale score.

Moblity scale

The mobility scale has 4 items (flexion, abduction, internal & external rotation):

1. Scores for flexion, adbuction & internal rotation are summed
2. The score for external rotation is determined by counting all checked items. Each checked item represents two points.
3. Scores from point 1 and 2 are summed to obtain the mobility scale score

Strength scale

The score is calculated from the highest score of 3 attempts. The score in points corresponds to the force in pounds (max 25 points).

Note: We measure strength in kilograms so the entered values are multiplied by 2.2

Total scale

The sum of all the scores above.

Clinical interpretation

The total CMS scores ranges from 0 points (most disability) to 100 points (least disability).

References

[1] Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clinical Orthopaedics & Related Research. 1987;214:160–164.: https://www.researchgate.net/publication/19369675_A_Clinical_Method_of_Functional_Assessment_of_the_Shoulder
[2] Constant CR, Gerber C, Emery RJ, Søjbjerg JO, Gohlke F, Boileau P. A review of the Constant score: modifications and guidelines for its use. J Shoulder Elbow Surg. 2008;17(2):355-361. doi:10.1016/j.jse.2007.06.022
[3] Vrotsou, K., Ávila, M., Machón, M. et al. Constant–Murley Score: A systematic review and standardized evaluation in different shoulder pathologies. Qual Life Res 27, 2217–2226 (2018). https://doi.org/10.1007/s11136-018-1875-7