Enrique Lluch1, Josep Benítez2, Lirios Dueñas3, José Casaña3, Yasser Alakhdar3, Jo Nijs4, Filip Struyf5. 1. Professor, Department of Physical Therapy, University of Valencia, Valencia, Spain; Researcher, Pain in Motion Research Group, Departments of Human Physiology and Physiotherapy, Faculty of Physical Education & Rehabilitation, Vrije Universiteit, Brussel, Belgium. Electronic address: enrique.lluch@uv.es. 2. Professor, Department of Physical Therapy, University of Valencia, Valencia, Spain; Researcher, Pain in Motion Research Group, Departments of Human Physiology and Physiotherapy, Faculty of Physical Education & Rehabilitation, Vrije Universiteit, Brussel, Belgium. 3. Professor, Department of Physical Therapy, University of Valencia, Valencia, Spain. 4. Researcher, Pain in Motion Research Group, Departments of Human Physiology and Physiotherapy, Faculty of Physical Education & Rehabilitation, Vrije Universiteit, Brussel, Belgium; Professor, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium. 5. Researcher, Pain in Motion Research Group, Departments of Human Physiology and Physiotherapy, Faculty of Physical Education & Rehabilitation, Vrije Universiteit, Brussel, Belgium; Professor, Division of Musculoskeletal Physiotherapy, Department of Health Sciences, Artesis University College Antwerp, Antwerp, Belgium.
Abstract
OBJECTIVE: The purpose of this study was to examine intertester and intratester reliability of the shoulder medial rotation test (MRT) and reliability differences depending on examiner expertise. METHODS: Seventeen athletes with chronic shoulder pain participated in the study. Four independent observers with different experience levels simultaneously rated MRT performance as "correct" or "incorrect," after a standardized assessment protocol, the same day (for intertester reliability) and in a 7-day interval (for intratester reliability). RESULTS: The intrarater reliability was admissible for 2 experts and one novice, with κ values ranging between 0.32 to 0.76 and poor for one novice (κ <0). Interrater agreement for all 4 assessors demonstrated slight agreement (κ = 0.06; 95% confidence interval: 0.06-0.47), increasing to fair agreement (κ = 0.33; 95% confidence interval: 0.21-0.69) when comparing the MRT findings between the 2 experienced assessors. Practice with the MRT in novices only marginally improved their level of agreement. CONCLUSIONS: Reliability of the MRT for detecting movement control of the shoulder girdle was fair at best for experienced examiners and poor overall. Dexterity and repetitive performance of the test is necessary for correct interpretation of the MRT.
OBJECTIVE: The purpose of this study was to examine intertester and intratester reliability of the shoulder medial rotation test (MRT) and reliability differences depending on examiner expertise. METHODS: Seventeen athletes with chronic shoulder pain participated in the study. Four independent observers with different experience levels simultaneously rated MRT performance as "correct" or "incorrect," after a standardized assessment protocol, the same day (for intertester reliability) and in a 7-day interval (for intratester reliability). RESULTS: The intrarater reliability was admissible for 2 experts and one novice, with κ values ranging between 0.32 to 0.76 and poor for one novice (κ <0). Interrater agreement for all 4 assessors demonstrated slight agreement (κ = 0.06; 95% confidence interval: 0.06-0.47), increasing to fair agreement (κ = 0.33; 95% confidence interval: 0.21-0.69) when comparing the MRT findings between the 2 experienced assessors. Practice with the MRT in novices only marginally improved their level of agreement. CONCLUSIONS: Reliability of the MRT for detecting movement control of the shoulder girdle was fair at best for experienced examiners and poor overall. Dexterity and repetitive performance of the test is necessary for correct interpretation of the MRT.