Western Ontario Shoulder Instability Index (WOSI)
Measures functional disability/symptoms related to shoulder instability across physical, activity, lifestyle, & emotion.
Provided by
EVAL FoundationInstructions
Assess your shoulder symptoms and functional limitations over the past week.
Rate your experience on a 0-100% scale, where 0% means no problem and 100% means the worst possible problem.
Responses are reported as whole number percentages.
Shoulder Information
The Western Ontario Shoulder Instability Index (WOSI) is a 21-item, shoulder-specific, self-administered questionnaire measuring functional disability in patients with shoulder instability.
The WOSI comprises four sub-scales:
Physical Symptoms (10 items, 0-1000 points)
Sports/Recreation/Work (4 items, 0-400 points)
Lifestyle (3 items, 0-300 points)
Emotion (3 items, 0-300 points)
The WOSI yields a total score of 0-2100 points with higher scores indicating greater disability. Each item is rated 0-100% by the patient.
The instrument has demonstrated excellent reliability, validity, and responsiveness in evaluating treatment outcomes and functional capacity in shoulder instability populations, making it valuable for baseline assessment, progress monitoring, and comparative effectiveness research.
Original Literature:
Kirkley, Alexandra, et al. “The development and evaluation of a disease-specific quality of life measurement tool for shoulder instability.” The American Journal of Sports Medicine 26.6 (1998): 764-772.
Additional Literature:
Salomonsson, Björn, et al. “The Western Ontario Shoulder Instability Index (WOSI): validity, reliability, and responsiveness retested with a Swedish translation.” Acta orthopaedica 80.2 (2009): 233-238.
Angst, Felix, et al. “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.S11 (2011).
All questions & possible results
Shoulder Information
Dominant Hand
Select one option:
- Right
- Left
- Both
Affected Shoulder
Select one option:
- Right
- Left
Physical Symptoms
Questions concerning physical symptoms experienced in the last week due to shoulder problems.
1. How much pain do you experience in your shoulder with overhead activities?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
2. How much aching or throbbing do you experience in your shoulder?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
3. How much weakness or lack of strength do you experience in your shoulder?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
4. How much fatigue or lack of stamina do you experience in your shoulder?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
5. How much clicking, cracking or snapping do you experience in your shoulder?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
6. How much stiffness do you experience in your shoulder?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
7. How much discomfort do you experience in your neck muscles as a result of your shoulder?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
8. How much feeling of instability or looseness do you experience in your shoulder?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
9. How much do you compensate for your shoulder with other muscles?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
10. How much loss of range of motion do you have in your shoulder?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
Sports/Recreation/Work
Questions concerning how the shoulder problem has affected work, sports, or recreational activities in the past week.
11. How much has your shoulder limited the amount you can participate in sports or recreational activities?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
12. How much has your shoulder affected your ability to perform the specific skills required for your sport or work?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
13. How much do you feel the need to protect your arm during activities?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
14. How much difficulty do you experience lifting heavy objects below shoulder level?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
Lifestyle
Questions concerning the amount the shoulder problem has affected or changed your lifestyle in the past week.
15. How much fear do you have of falling on your shoulder?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
16. How much difficulty do you experience maintaining your desired level of fitness?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
17. How much difficulty do you have "rough housing" or "horsing around" with family or friends?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
18. How much difficulty do you have sleeping because of your shoulder?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
Emotion
Questions relating to how you have felt in the past week with regard to your shoulder problem.
19. How much conscious are you of your shoulder?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
20. How concerned are you about your shoulder becoming worse?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
21. How much frustration do you feel because of your shoulder?
0-100% scale, where 0% means no problem and 100% means the worst possible problem.
A number between 0 and 100 (whole numbers), in %.
Possible results
Pertinent Positive: Loss of range of motion in the shoulder
Score 1-49%
Pertinent Positive: Stiffness in the shoulder
Score >49%
Pertinent Positive: Loss of range of motion in the shoulder
Score >49%
Pertinent Positives: Pain in the shoulder with overhead activities
Score 1-49%
Pertinent Positive: Difficulty maintaining desired level of fitness
Score >49%
Pertinent Negative: Concern about the shoulder becoming worse
Score=0
Pertinent Positive: Fear of falling on the shoulder
Score 1-49%
Lifestyle
Pertinent Positive: Difficulty lifting heavy objects below shoulder level
Score >49%
Pertinent Positive: Conscious of the shoulder
Score >49%
Pertinent Negative: Need to protect arm during activities
Score=0
Pertinent Negative: Fatigue or lack of stamina in the shoulder
Score=0
Pertinent Positive: Discomfort in neck muscles as a result of the shoulder
Score 1-49%
Pertinent Negative: Pain in the shoulder with overhead activities
Score=0
Pertinent Positive: Feeling of instability or looseness in the shoulder
Score >49%
Pertinent Negative: Conscious of the shoulder
Score=0
Pertinent Negative: Difficulty "rough housing"/"horsing around"
Score=0
Pertinent Negative: Difficulty lifting heavy objects below shoulder level
Score=0
Pertinent Positive: Clicking, cracking, or snapping in the shoulder
Score >49%
Pertinent Positive: Fear of falling on the shoulder
Score >49%
Pertinent Positive: Clicking, cracking, or snapping in the shoulder
Score 1-49%
Pertinent Negative: Discomfort in neck muscles as a result of the shoulder
Score=0
Pertinent Negative: Compensation for the shoulder with other muscles
Score=0
Pertinent Positive: Aching or throbbing in the shoulder
Score 1-49%
Pertinent Negative: Fear of falling on the shoulder
Score=0
Pertinent Positive: Difficulty lifting heavy objects below shoulder level
Score 1-49%
Pertinent Positive: Weakness or lack of strength in the shoulder
Score >49%
Pertinent Negative: Difficulty maintaining desired level of fitness
Score=0
Pertinent Negative: Clicking, cracking, or snapping in the shoulder
Score=0
Pertinent Negative: Shoulder affected specific skills of sport or work
Score=0
Pertinent Positive: Difficulty sleeping because of the shoulder
Score >49%
Pertinent Positive: Difficulty "rough housing"/"horsing around"
Score >49%
Pertinent Positive: Compensation for the shoulder with other muscles
Score 1-49%
Physical Symptoms
Pertinent Positive: Difficulty "rough housing"/"horsing around"
Score 1-49%
Pertinent Negative: Weakness or lack of strength in the shoulder
Score=0
Pertinent Positive: Shoulder affected specific skills of sport or work
Score >49%
Pertinent Positive: Conscious of the shoulder
Score 1-49%
Pertinent Positives: Pain in the shoulder with overhead activities
Score >49%
Pertinent Negative: Frustration because of the shoulder
Score=0
Pertinent Positive: Need to protect arm during activities
Score >49%
Pertinent Positive: Fatigue or lack of stamina in the shoulder
Score >49%
Pertinent Positive: Weakness or lack of strength in the shoulder
Score 1-49%
Pertinent Positive: Need to protect arm during activities
Score 1-49%
Pertinent Positive: Shoulder affected specific skills of sport or work
Score 1-49%
Pertinent Positive: Concern about the shoulder becoming worse
Score 1-49%
Pertinent Positive: Frustration because of the shoulder
Score 1-49%
Pertinent Negative: Difficulty sleeping because of the shoulder
Score=0
Pertinent Positive: Difficulty sleeping because of the shoulder
Score 1-49%
Pertinent Positive: Frustration because of the shoulder
Score >49%
Pertinent Positive: Discomfort in neck muscles as a result of the shoulder
Score >49%
Pertinent Negative: Feeling of instability or looseness in the shoulder
Score=0
Pertinent Positive: Feeling of instability or looseness in the shoulder
Score 1-49%
Pertinent Positive: Compensation for the shoulder with other muscles
Score >49%
Pertinent Positive: Shoulder limited sports and recreational activities
Score >49%
Pertinent Negative: Stiffness in the shoulder
Score=0
Pertinent Negative: Loss of range of motion in the shoulder
Score=0
Pertinent Negative: Aching or throbbing in the shoulder
Score=0
Pertinent Positive: Concern about the shoulder becoming worse
Score >49%
Pertinent Positive: Aching or throbbing in the shoulder
Score >49%
Pertinent Positive: Shoulder limited sports and recreational activities
Score 1-49%
Pertinent Positive: Fatigue or lack of stamina in the shoulder
Score 1-49%
Pertinent Positive: Difficulty maintaining desired level of fitness
Score 1-49%
Pertinent Positive: Stiffness in the shoulder
Score 1-49%
Pertinent Negative: Shoulder limited sports and recreational activities
Score=0
Citation
Kirkley, Alexandra, et al. “The development and evaluation of a disease-specific quality of life measurement tool for shoulder instability.” The American Journal of Sports Medicine 26.6 (1998): 764-772.
