There exists a large number of instruments that measure symptoms and function of the shoulder. More than 30 different tools can be found by entering “shoulder” and “assessment” into PubMed and conducting a review of the ≥3,000 retrieved references. Literature for every instrument was systematically reviewed by the key words “shoulder” and “instrument's name.” We selected those that are cited in at least 20 references and for which psychometric testing has been reported. For each of these 9 tools, the 10–20 most informative studies about psychometric results were selected for citation to limit the references' lists, but the entire body of literature was reviewed.
The Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH), together with its short form (QuickDASH), is the most widespread and best-tested and characterized instrument for shoulder assessment. However, it is region specific, i.e., specific to the arm, not just to the shoulder. The DASH stands out as an instrument positioned between the generic (as, for example, the Short Form 36) and the shoulder-specific measures, i.e., all other tools of the review: it forms the link between these 2 philosophies. It is a must for comprehensive assessment in conditions affecting different regions of the arm and for research studies. This review was focused only on shoulder studies of the DASH/QuickDASH.
The Shoulder Pain and Disability Index (SPADI), the Constant (Murley) Score (CS), and the American Shoulder and Elbow Surgeons (ASES) questionnaire for the shoulder are also well characterized and accepted in the scientific community. Their responsiveness is comparable. The SPADI is, together with the patient ASES, the shortest self-assessment and shows high validity. The ASES is a sophisticated measure for the patient and the examiner offering a relatively large number of items, often too long for clinicians. There are sparse data about the clinical (examiner-based) part of the ASES. The CS is the shortest self- and examiner-based tool. It combines the data of both into 1 total score. However, its intertester reliability is low and its validity is affected by the problem of different protocols on how to measure strength.
The Simple Shoulder Test (SST) is very short, very easy to understand and to score, and widely used in US. The binary item-response options (yes/no) affect the usability of the SST as metric score, validity, and comparability to other scores; the same is true for the Shoulder Disability Questionnaire (SDQ). The Oxford Shoulder Score was developed specifically for surgical conditions and is often used in the UK. It is very short, but there is a lack of psychometric testing data. The SDQ is very short but cannot be recommended due to absence of data on or weakness of psychometric properties.
Finally, the Western Ontario Shoulder Instability index (WOSI) was selected because, in the last few years, it has become the most often used and best psychometrically tested assessment of shoulder instability, although there is still a lack of testing data.
For a set of clinical assessment tools, we recommend the QuickDASH, the SPADI (or the patient ASES), and the CS, and the WOSI if instability is part of the condition. For a research set, the DASH, the SPADI, and, possibly, the clinical part of the ASES or the CS can be recommended in order to (also) obtain more information about examiner-based data.