Reliability of physical examination tests used in the assessment of patients with shoulder problems: a systematic review.

MAY, Stephen, CHANCE-LARSEN, Kenneth, LITTLEWOOD, Chris, LOMAS, David and SAAD, Mahmoud (2010). Reliability of physical examination tests used in the assessment of patients with shoulder problems: a systematic review. Physiotherapy, 96 (3), 179-190.

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Link to published version:: 10.1016/j.physio.2009.12.002

Abstract

Background: Shoulder pain is a common clinical problem, and numerous tests are used to diagnose structural pathology.

Objectives: To systematically review the reliability of physical examination procedures used in the clinical examination of patients with shoulder pain.

Data sources: MEDLINE, PEDro, AMED, PsychInfo, Cochrane Library (2009) and CINAHL were searched from the earliest record on the database to June 2009.

Study eligibility criteria: Reliability studies that included any patients with shoulder pain were analysed for their quality and reliability results.

Study appraisal and synthesis methods: Pre-established criteria were used to judge the quality of the studies (high quality >60% methods score) and satisfactory levels of reliability (kappa or intraclass correlation coefficient ≥0.85, sensitivity analysis 0.70). A qualitative synthesis was performed based on levels of evidence.

Results: Thirty-six studies were included with a mean methods score of 57%. Seventeen studies were deemed to be of high quality; high quality studies were less likely to meet the pre-agreed level of reliability. The majority of studies indicated poor reliability for all procedures investigated.

Limitations: Overall, the evidence regarding reliability was contradictory.

Conclusions and implications: There is no consistent evidence that any examination procedure used in shoulder assessments has acceptable levels of reliability. Alternate methods of classification which are reliable should be used to classify patients with shoulder problems.

Item Type: Article
Research Institute, Centre or Group: Centre for Health and Social Care Research
Identification Number: 10.1016/j.physio.2009.12.002
Depositing User: Rebecca Jones
Date Deposited: 08 Mar 2012 09:21
Last Modified: 08 Mar 2012 09:21
URI: http://shura.shu.ac.uk/id/eprint/4488

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