Constant Murley Score (CMS)

What is the Constant Murley Score (CMS)?

The Constant Murley Score (CMS) is a clinical tool (and a partly patient-reported outcome measure) used to evaluate shoulder functionality, specifically assessing pain, the ability to perform daily activities, range of motion, and strength. Healthcare professionals widely use it to gauge the severity of shoulder conditions, checking for shoulder instability, and to monitor treatment progress over time.

Several journals, including the Journal of Shoulder and Elbow Surgery (J Shoulder Elbow Surg), often use this tool for research and discussing findings, so you know that this is a tool approved by elbow surgeons, shoulder specialists, etc.

How is the constant score used?

The first portion of the constant score is a patient-reported assessment. For this part, the patient simply needs to rate their shoulder pain when performing ordinary activities and answer questions based on how their shoulder pain affects their daily life. The second part requires you to conduct physical tests to assess shoulder movement and strength.

How is it scored?

The Constant Murley Shoulder Score is scored out of a total of 100 points, divided into four main components:

1. Pain score (15 points): This section evaluates the intensity and frequency of shoulder pain experienced by the patient. The constant score is based on the patient's self-reported pain level, ranging from no pain (15 points) to severe pain (0 points).
2. Activities of daily living (20 points): This component assesses the patient's ability to perform common daily activities such as personal hygiene, dressing, and work-related tasks. The score is assigned based on the patient's capability to carry out these activities independently or with difficulty.
3. Range of motion (40 points): This section measures the shoulder's range of motion in different directions, including flexion, abduction, internal rotation, and external rotation. Each movement is scored individually, and the total score is the sum of these measurements, reflecting the overall flexibility and mobility of the shoulder joint.
4. Strength (25 points): This component evaluates the strength of the shoulder muscles, typically measured using a spring balance or similar device. The score is determined by the maximum weight the patient can hold with the arm in 90 degrees of abduction.

Next steps after using this score

After calculating the CMS, healthcare providers can determine the severity of the shoulder condition and formulate a treatment plan. A higher score indicates better shoulder function, while a lower score suggests more significant impairment.

Based on the score, a treatment strategy may include physical therapy, medication, or, in some cases, surgery. Regular reassessment using the CMS can help track the effectiveness of the treatment and make necessary adjustments.

You may also use other assessments like the Shoulder Disability Questionnaire, Oxford Shoulder Score, and other functional assessments for measuring shoulder injury, function, movement, etc., to get consistent and more comprehensive results before you make definitive diagnoses of shoulder pathologies (like rotator cuff diseases) and decide on what treatments to provide, especially if shoulder surgery is in the cards.

How to use our CMS template

Using our CMS template is straightforward and efficient, designed to streamline the assessment of shoulder function. Follow these steps to ensure accurate scoring and evaluation of this simple shoulder test:

Step 1: Download the template

Access our CMS template from this page by clicking on "Use template" or "Download". You can also find it in the Carepatron app.

Step 2: Give your patient a copy

This CMS template features both a patient portion and a physician portion, allowing for subjective and objective measurements. Ask your patient to complete the patient portion independently. This will save time and allow for a more efficient evaluation during your session.

Step 3: Perform the tests included in the template

Once your patient has filled out their portion of the template, you can use it to assess their shoulder function. Perform the tests in the template to evaluate the active range of motion, posture, and pain levels in patients with shoulder injuries or conditions.

Step 4: Score and document your findings

Using our CMS template makes scoring the tests quick and easy. Simply follow the instructions included in the template to score each component of the CMS template.

Benefits of using this score

The Constant Murley Shoulder Assessment offers numerous benefits for healthcare professionals and patients. As a standardized and comprehensive tool, it provides a reliable method for evaluating shoulder function and ensures consistent assessments of adult shoulder function across different practitioners and settings.

• Comprehensive evaluation: The CMS assesses multiple aspects of shoulder function, including pain, daily activities, range of motion, and strength.
• Objective measurements: The CMS minimizes evaluation subjectivity by providing clear criteria and scoring guidelines. This objectivity ensures that assessments are accurate and comparable over time and between different evaluators.
• Tracking progress: Regular use of the CMS allows healthcare providers to monitor changes in shoulder function over time. This is particularly useful for assessing the effectiveness of treatments and making necessary adjustments to optimize patient outcomes.
• Treatment planning: The detailed information gathered through the CMS helps clinicians identify various shoulder pathologies and develop targeted treatment plans. By identifying specific areas of impairment, providers can tailor interventions to address the patient's unique needs.
• Enhanced communication: The CMS's standardized nature facilitates clear communication between healthcare providers, patients, and other stakeholders.

Overall, the Constant Murley Score is a valuable tool for enhancing the quality of shoulder care, resulting in improved patient outcomes and more effective treatments.