American Shoulder and Elbow Surgeons Shoulder Score (ASES)

Objective

The ASES is a standardized form which aims to measure pain and functional limitations in patients suffering from musculoskeletal disorders of the shoulder and elbow (Angst et al., 2011).

Interpretation

A low score corresponds to a high level of pain and impairment.

Execution

Tthe ASES is a scale out of 100 points which includes the evaluation of two dimensions: pain and activities of daily living (ADLs).

The ASES also contains a section filled out by the physician, which comprises the first six questions, and a self-evaluation section filled out by the patient (p-ASES), from the seventh question onward. The seventh question is an evaluation of pain levels. It is measured on the VAS (10 - VAS score out of 10 points) and is multiplied by 5 to give a total score out of a maximum of 50 points. The ADLs are evaluated over 10 items (questions 8 to 17), each item having a maximum score of 3 points, giving a total maximum score of 30 points. This score is multiplied by 5/3 to give a total score out of 50 points. The pain and functional scores are then added up to obtain the final ASES score.

Time Needed

Patients can fill out the questionnaire in less than 5 minutes (Leggin et al., 2006).

Clinical Value

The psychometric properties of the ASES are well-established and its validity, reliability, and sensitivity to change have been evaluated for different shoulder conditions: rotator cuff injuries, glenohumeral arthritis, instability and osteoarthritis of the shoulder, and shoulder arthroplasty (Wylie et al., 2014). However, the methodology for grading symptoms remains complicated.

Acknowledgements

We thank Mr Loïc Bareyre for allowing us to make the ASES available on Fullphysio.

Angst, Felix, Jörg Goldhahn, Susann Drerup, André Aeschlimann, Hans-Kaspar Schwyzer, and Beat R. Simmen. “Responsiveness of Six Outcome Assessment Instruments in Total Shoulder Arthroplasty.” Arthritis and Rheumatism 59, no. 3 (March 15, 2008): 391–98.

Angst, Felix, Hans-Kaspar Schwyzer, André Aeschlimann, Beat R. Simmen, and Jörg Goldhahn. “Measures of Adult Shoulder Function: Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and Its Short Version (QuickDASH), Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) Society Standardized Shoulder Assessment Form, Constant (Murley) Score (CS), Simple Shoulder Test (SST), Oxford Shoulder Score (OSS), Shoulder Disability Questionnaire (SDQ), and Western Ontario Shoulder Instability Index (WOSI).” Arthritis Care & Research 63 Suppl 11 (November 2011): S174-188.

Leggin, Brian G., Lori A. Michener, Michael A. Shaffer, Susan K. Brenneman, Joseph P. Iannotti, and Gerald R. Williams. “The Penn Shoulder Score: Reliability and Validity.” Journal of Orthopaedic & Sports Physical Therapy 36, no. 3 (March 1, 2006): 138–51.

Wylie, James D., James T. Beckmann, Erin Granger, and Robert Z. Tashjian. “Functional Outcomes Assessment in Shoulder Surgery.” World Journal of Orthopedics 5, no. 5 (November 18, 2014): 623–33.

‍