You are here

Article Text

Article menu
XML
Sports and exercise medicine
Research
Inter-examiner reproducibility of clinical tests and criteria used to identify subacromial impingement syndrome
  1. Mikkel Vind1,
  2. Søren Bie Bogh1,
  3. Camilla Marie Larsen2,
  4. Hans Kromann Knudsen1,
  5. Karen Søgaard2,
  6. Birgit Juul-Kristensen2
  1. 1Department of Physiotherapy, University College Lillebaelt, Odense, Denmark
  2. 2Research Unit for Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
  1. Correspondence to Mikkel Vind; vindbie{at}live.dk

Abstract

Introduction A specific algorithm has been proposed for classifying impingement related shoulder pain in athletes with overhead activity. Data on the inter-examiner reproducibility of the suggested clinical tests and criteria and their mutual dependencies for identifying subacromial impingement symptoms (SIS) are not available.

Objective To test the inter-examiner reproducibility of selected tests and criteria suggested for classifying SIS and the mutual dependencies of each of the individual tests and SIS.

Method A standardised three-phase protocol for clinical reproducibility studies was followed, consisting of a training, an overall agreement and a study phase. To proceed to the study phase, an overall agreement of 0.80 was required. In total 10, 20 and 44 subjects were included in the three phases, respectively. The case prevalence in the study phase was 50%. The inclusion criterion for cases was ≥3, and for controls ≤1 positive test out of four. Cohen's κ statistics were used for calculating agreement.

Results In the overall agreement phase, an agreement of 0.90 was obtained, while in the study phase it was 0.98 with a κ of 0.95 for SIS. κ Values for the individual tests varied between 0.60 and 0.95. Mutual dependencies between each test and SIS showed Neer's test with anterior pain to be most often used to determine SIS.

Conclusions Inter-examiner reproducibility was moderate to almost perfect for the selected tests and criteria for SIS. The next challenge will be to establish reproducibility in clinical practice, as well as the validity of the tests and criteria for SIS.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

https://doi.org/10.1136/bmjopen-2010-000042

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Supplementary materials

    Footnotes

    • To cite: Vind M, Bogh SB, Larsen CM, et al. Inter-examiner reproducibility of clinical tests and criteria used to identify subacromial impingement syndrome. BMJ Open 2011;1:e000042. doi:10.1136/bmjopen-2010-000042

    • Category: Clinical study.

    • Funding The National Research Fund for Health and Disease, the Research Fund for the Region of Southern Denmark, the Arthritis Research Association, and the Danish Physiotherapy Research Foundation.

    • Competing interests None.

    • Patient consent Obtained.

    • Ethics approval The study was approved by the Ethics Committee in Science of the Region of Southern Denmark.

    • Contributors MV contributed to the conception, design of the study and writing of the article, the description of the tests and practical performance of the study, conducted the statistical analysis, and drafted and approved the final manuscript. SBB contributed to the conception, design of the study and writing of the article, the description of the test manual and practical performance of the study, conducted the statistical analysis, and drafted and approved the final manuscript. CML contributed to the description of the test manual and revised and approved the final manuscript. HKK contributed to the conception and design of the study, contributed to the description of the test manual, and revised and approved the final manuscript. KS contributed to the conception and design of the study, and revised and approved the final manuscript. BJK contributed to the conception, design of the study and writing of the article, and the description of the test manual, and revised and approved the final manuscript. All the authors will act as guarantors for the paper.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Data in 2×2 contingency tables, and the dataset are available from the corresponding author at vindbie{at}live.dk. Participants gave informed consent for data sharing.