American Shoulder and Elbow Surgeons score

American Shoulder and Elbow Surgeons score (ASES) is designed to assess the condition of the shoulder, regardless of disease pathology. It was originally published in 1994 in the Journal of Shoulder and Elbow Surgery.

The ASES is a composite instrument, requiring both a physician assessment and a patient-completed portion; however, it is commonly presented as solely the patient-reported survey. This includes a section on pain (7 items) and a section on activities of daily living (10 items). Scores range from 0 to 100 with a score of 0 indicating a worse shoulder condition and 100 indicating a better shoulder condition.

See Also: Shoulder Pain and Disability Index (SPADI)

American Shoulder and Elbow Surgeons score items

1. Usual Work
2. Usual sport/leisure activity
3. Do you have shoulder pain at night?
4. Do you take pain killers such as paracetamol (acetaminophen), diclofenac, or ibuprofen?
5. Do you take strong pain killers such as codeine, tramadol, or morphine?
6. How many pills do you take on an average day?
7. Intensity of pain (scale from 0 to 10)
8. Is it difficult for you to put on a coat?
9. Is it difficult for you to sleep on the affected side?
10. Is it difficult for you to wash your back/do up bra?
11. Is it difficult for you to manage toiletting?
12. Is it difficult for you to comb your hair?
13. Is it difficult for you to reach a high shelf?
14. Is it difficult for you to lift 10lbs. (4.5kg) above your shoulder?
15. Is it difficult for you to throw a ball overhand?
16. Is it difficult for you to do your usual work?
17. Is it difficult for you to do your usual sport/leisure activity?

The ASES scores showed a broad range of baseline scores for patients choosing to undergo rotator cuff repair highlighting the need for individual patient rather than population review of patient-reported outcome measures. As shared decision-making is taking on a larger role in clinical care, it is important to counsel patients accurately. Evaluating the ASES score by MCID and maximal possible improvement provides different population perspectives with the concept of RIPAR allowing for personalization of decision-making on the individual patient level.

References & More

1. Richards, Robin R., et al. “A standardized method for the assessment of shoulder function.” Journal of Shoulder and Elbow Surgery 3.6 (1994): 347-352. Pubmed
2. Roy JS, MacDermid JC, Woodhouse LJ. Measuring shoulder function: a systematic review of four questionnaires. Arthritis Rheum. 2009 May 15;61(5):623-32. doi: 10.1002/art.24396. PMID: 19405008.
3. Michener LA, McClure PW, Sennett BJ. American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, patient self-report section: reliability, validity, and responsiveness. J Shoulder Elbow Surg. 2002 Nov-Dec;11(6):587-94. doi: 10.1067/mse.2002.127096. PMID: 12469084. Pubmed
4. Schmidt S, Ferrer M, González M, González N, Valderas JM, Alonso J, Escobar A, Vrotsou K; EMPRO Group. Evaluation of shoulder-specific patient-reported outcome measures: a systematic and standardized comparison of available evidence. J Shoulder Elbow Surg. 2014 Mar;23(3):434-44. doi: 10.1016/j.jse.2013.09.029. Epub 2014 Jan 7. PMID: 24406123. Pubmed
5. Netter’s Orthopaedic Clinical Examination An Evidence-Based Approach 3rd Edition Book.