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Date of completion
The Western Ontario Shoulder Instability Index (WOSI)    
Clinician's name (or ref) Patient's name (or ref)
 
The following questions concern the symptoms you have experienced due to your shoulder problem. In all cases, please enter the amount of the symptom you have experienced in the last week. (please move the slider on the horizontal line.)  
1. How much pain do you experience in your shoulder with overhead activities?   12. How much has your shoulder affected your ability to perform the specific skills required for your sport or work? (If your shoulder affects both sports and work, consider the area that is most affected.)
No pain
Extreme pain
 
Not affected
Extremely affected
     
2. How much aching or throbbing do you experience in your shoulder?   13. How much do you feel the need to protect your arm during activities?
No aching/throbbing
Extreme aching/throbbing
 
Not at all
Extreme
     
3. How much weakness or lack of strength do you experience in your shoulder?   14. How much difficulty do you experience lifting heavy objects below shoulder level
No weakness
Extreme weakness
 
No difficulty
Extreme difficulty
     
4. How much fatigue or lack of stamina do you experience in your shoulder?   15. How much fear do you have of falling on your shoulder?
No fatigue
Extreme fatigue
 
No fear
Extreme fear
     
5. How much clicking, cracking or snapping do you experience in your shoulder?   16. How much difficulty do you experience maintaining your desired level of fitness
No clicking
Extreme clicking
 
No difficulty
Extreme difficulty
     
6. How much stiffness do you experience in your shoulder?   17. How much difficulty do you have “roughhousing” or “horsing around” with family or friends
No stiffness
Extreme stiffness
 
No difficulty
Extreme difficulty
7. How much discomfort do you experience in your neck muscles as a result of your shoulder?   18. How much difficulty do you have sleeping because of your shoulder
No discomfort
Extreme discomfort
 
No difficulty
Extreme difficulty
8. How much feeling of instability or looseness do you experience in your shoulder?   19. How conscious are you of your shoulder
No instability
Extreme instability
 
Not conscious
Extremely conscious
9. How much do your compensate for your shoulder with other muscles?   20. How concerned are you about your shoulder becoming worse
Not at all
Extreme
 
No concern
Extremely concerned
10. How much loss of range of motion do you have in your shoulder?   21. How much frustration do you feel because of your shoulder
No loss
Extreme loss
 
No frustration
Extremely frustrated
11. How much has your shoulder limited the amount you can participate in sports or recreational activities?    
Not limited
Extremely limited
     

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Physical symptoms Score is:   %
Sports/recreation/work Score is:   %
Lifestyle Score is:   %
Emotion Score is:   %
The WOSI Score is:   %
Link for Reference: The Development and Evaluation of a Disease-Specific Quality of Life Measurement Tool for Shoulder Instability
The Western Ontario Shoulder Instability Index (WOSI)Am J Sports Med November 1998 vol. 26 no. 6 764-772
Alexandra Kirkley, MD, FRCSC*, Sharon Griffin, CSS, Heidi McLintock, BSc, PT, MSc and, Linda Ng, BSc, PT, http://ajs.sagepub.com/content/26/6/764.abstract