Key facts
- Score direction
- Higher is better
- Meaningful change
- The minimal important change (MIC) is approximately 6 points on the 0-48 scale (van der Linde et al. 2017). The standard error of measurement (SEM) is 3.3 points and the smallest detectable change (SDC) is 9 points (van der Linde et al. 2015).
- Scoring
- Each of the 12 items is scored from 0 (worst) to 4 (best) using the revised 2009 scoring convention applied across the Oxford instruments. The total score is the sum of all items (0 to 48); higher scores indicate less im…
About the Oxford Shoulder Instability Score
The Oxford Shoulder Instability Score is a validated patient-reported outcome measure developed at the University of Oxford to assess the outcome of surgical and non-surgical treatment in patients with unidirectional or multidirectional shoulder instability, including recurrent dislocation and subluxation. Its 12 items were derived from patient interviews and cover pain, function, social and psychological impact, and are not suitable for scoring outcome until at least 6 months after surgery.
Medical Specialties
Anatomic Areas
Clinical Indications
Developer Information
Developed by Dr Jill Dawson and Professor Ray Fitzpatrick at the Health Services Research Unit, University of Oxford, in association with Professor Andrew Carr at the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford.
Origin
Built on Patient Watch - an open-source community form. It is not validated or endorsed by any copyright holder.
Administration Instructions
Select one option for every question. Not suitable for assessing outcome in post-operative patients until 6 months after surgery.
Scoring Methodology
Each of the 12 items is scored from 0 (worst) to 4 (best) using the revised 2009 scoring convention applied across the Oxford instruments. The total score is the sum of all items (0 to 48); higher scores indicate less impairment. The original 1999 publication scored items 1 (worst) to 5 (best), giving a total of 12 to 60; convert with new_total = 60 - old_total. Unlike the Oxford Shoulder Score, OSIS has no validated pain/function subscales - it is reported as a single total only.
Meaningful Change Threshold
The minimal important change (MIC) is approximately 6 points on the 0-48 scale (van der Linde et al. 2017). The standard error of measurement (SEM) is 3.3 points and the smallest detectable change (SDC) is 9 points (van der Linde et al. 2015).
Score Interpretation
Understanding what your score means
severe
0 - 19Severe shoulder instability with major impact on pain, function and daily life
moderate
20 - 29Moderate to severe instability symptoms affecting function, activity avoidance and confidence in the shoulder
mild
30 - 39Mild to moderate instability symptoms with some limitation of activities
satisfactory
40 - 48Satisfactory shoulder stability with minimal symptoms and little impact on daily life
Clinical Limitations & Considerations
The OSIS is unidimensional with no validated subscales, unlike the Oxford Shoulder Score. It is not suitable for assessing outcome in post-operative patients until at least 6 months after surgery. No minimal important change was established until 2017; earlier studies reported only the smallest detectable change (SDC, ~9 points). Cultural and linguistic adaptations may be needed for non-English speaking populations. It should form part of a broader clinical assessment rather than a standalone diagnostic tool.
Supporting Literature
Key validation and development studies for the Oxford Shoulder Instability Score
- 1
The assessment of shoulder instability. The development and validation of a questionnaire
Dawson J, Fitzpatrick R, Carr A
The Journal of Bone and Joint Surgery. British volume, 1999
- 2
The Oxford Shoulder Instability Score; validation in Dutch and first-time assessment of its smallest detectable change
van der Linde JA, van Kampen DA, van Beers LWAH, van Deurzen DFP, Terwee CB, Willems WJ
Journal of Orthopaedic Surgery and Research, 2015
- 3
The Responsiveness and Minimal Important Change of the Western Ontario Shoulder Instability Index and Oxford Shoulder Instability Score
van der Linde JA, van Kampen DA, van Beers LWAH, van Deurzen DFP, Saris DBF, Terwee CB
Journal of Orthopaedic & Sports Physical Therapy, 2017
Used in Literature
Studies and publications that have used the Oxford Shoulder Instability Score
- 1
The assessment of shoulder instability. The development and validation of a questionnaire
Dawson J, Fitzpatrick R, Carr A
The Journal of Bone and Joint Surgery. British volume, 1999
Frequently asked questions
What does a mild Oxford Shoulder Instability Score score mean?
A Oxford Shoulder Instability Score score of 30 to 39 is classified as mild. Mild to moderate instability symptoms with some limitation of activities
What does a severe Oxford Shoulder Instability Score score mean?
A Oxford Shoulder Instability Score score of 0 to 19 is classified as severe. Severe shoulder instability with major impact on pain, function and daily life
What does a moderate Oxford Shoulder Instability Score score mean?
A Oxford Shoulder Instability Score score of 20 to 29 is classified as moderate. Moderate to severe instability symptoms affecting function, activity avoidance and confidence in the shoulder
What does a satisfactory Oxford Shoulder Instability Score score mean?
A Oxford Shoulder Instability Score score of 40 to 48 is classified as satisfactory. Satisfactory shoulder stability with minimal symptoms and little impact on daily life
Related Outcome Measures
Other clinical questionnaires for similar specialties and conditions
Oxford Shoulder Score
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Oxford Knee Score
Oxford Knee Score - a 12-item patient-reported outcome measure for assessing function and pain after total knee replacement surgery
QuickDASH
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