The Simple Shoulder Test (SST)

doctor raising woman's arm to examine

What is the Simple Shoulder Test? – A Focus on Functional Ability

The Simple Shoulder Test (SST) was created by the Shoulder Team at the University of Washington Department of Orthopedics and was first published in 1993. The team looked at common functional problems in their patients and then created the test to address them directly. It is a twelve (12) question patient-reported outcomes (PRO) measure that was designed to address general functionality rather than just range of motion.

Each question focuses on shoulder function by looking at intolerance to specific activities. Like many other PROs, it is administered prior to the operative procedure to establish a patient’s baseline, and then again at set intervals post-operatively to determine the change in the patient’s outcomes.

The format of the 12 question test is a simple yes/no, such as “Does your shoulder allow you to sleep comfortably?”. The questions are given even weight, with individual focus often being given to functional problems. The language of the questions is simple in nature and applies across a wide range of patient populations. However, there are several questions that address key areas for high-performance athletes, making the tool a crowd favorite amongst sports providers.

Strengths

The simplicity of the SST is one of its greatest strengths, consisting of a simple yes/no format. A second strength it possesses is its nearly perfect reproducibility. In normal subjects, the reproducibility is nearly 100%, and abnormal cases that were retested 5-14 days later had a 96% rate of those tests with no more than one question answered differently from the first time. Due to having general, simple questions, the tests showed that they applied across all patient populations. What also follows from a simple, reproducible test, is that outcomes can be easily and clearly communicated to patients. The fact that it is valid and reliable for both the general population and high-performance athletes makes it an easy 1 stop shop PROM tool. To boot, it is free to use and has no licensing requirements.

Considerations

When looking at potential drawbacks for the Simple Shoulder Test, it’s hard to come up with anything substantial. Because the SST relies on natural language for its test questions, one consideration for the test is its usefulness across language lines, where direct translations might be more difficult to validate. To address this concern, several studies have been done to validate the SST across other languages, including Spanish, Portuguese-Brazilian, and Persian. Apart from ongoing efforts to implement the SST more broadly, it has no clear defect as one of the simplest and most inexpensive PROs available.

Licensing and Cost

The Simple Shoulder Test (SST) does not require a license. Download here.

Sources

Questionnaire: How to Use the Simple Shoulder Test | Simple Shoulder Test | Simple Shoulder Test — OrthoToolKit | Validation of the Simple Shoulder Test in a Portuguese-Brazilian Population. Is the Latent Variable Structure and Validation of the Simple Shoulder Test Stable across Cultures?

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