Constant-Murley Score: systematic review and standardized evaluation in different shoulder pathologies

Area of Science:

• Orthopedics
• Rheumatology
• Physical Therapy

Background:

• The Constant-Murley Score (CMS) is widely used for shoulder evaluation.
• Its psychometric properties across diverse shoulder pathologies require thorough assessment.

Purpose of the Study:

• To systematically evaluate the reliability, validity, responsiveness, interpretability, and burden of the CMS.
• To assess CMS performance in specific shoulder conditions including subacromial pain, fractures, arthritis, instability, and frozen shoulder.

Main Methods:

• A comprehensive systematic review of MEDLINE and EMBASE databases was conducted.
• Expert evaluators utilized the Evaluating Measures of Patient Reported Outcomes (EMPRO) tool to assess CMS psychometric properties.
• Articles were categorized by patient pathology for detailed analysis.

Main Results:

• EMPRO scores varied significantly, with subacromial pathology scoring highest (58.6) and instability lowest (30.6).
• Responsiveness to change was the only consistently adequate attribute, except for frozen shoulder.
• Data on the concept and measurement model were insufficient, and other attributes showed high variability.

Conclusions:

• Current evidence does not establish the CMS as a definitive gold standard for all shoulder evaluations.
• CMS is recommended for subacromial pathology, but its utility for other conditions remains inconclusive.
• Further prospective studies are essential to validate CMS psychometric properties for fractures, arthritis, instability, and frozen shoulder.