Passive range of motion in patients with adhesive shoulder capsulitis, an intertester reliability study over eight weeks

Satya Pal Sharma, Anders Bærheim, Alice Kvåle, Satya Pal Sharma, Anders Bærheim, Alice Kvåle

Abstract

Background: Measuring range of motion (ROM) in the shoulder joint is important for the diagnosis and monitoring of change over time. To what degree passive ROM can be trusted as a reliable outcome measure was examined as part of an on-going randomized controlled trial for patients with shoulder capsulitis. The aim of this study was to examine intertester reliability of passive ROM in the shoulder joint over a period of eight weeks in patients with adhesive capsulitis stage II.

Methods: Fifty patients with a clinical diagnosis of adhesive shoulder capsulitis were examined by two independent testers. A predefined protocol was used for measuring passive range of motion with an inclinometer, a plurimeter, in both affected and non-affected shoulders three times; at the start of the study and after 4 and 8 weeks.

Results: Very good to excellent intertester agreements were found for most parameters for the affected arm at all three test points. The intraclass correlation coefficient (ICC 2.1) values ranged from 0.76 to 0.98, i.e. from very reliable to excellent. The measurement error was in general small for the affected arm (5°-7°). ICCs were slightly lower for the non-affected arm at 8 weeks, but with acceptable measurement errors.

Conclusions: Intertester reliability between two testers was very good at three visits over a time period of eight weeks using a plurimeter to measure passive range of motion in patients with adhesive shoulder capsulitis. This method can reliably determine passive range of motion in this patient population and be a reliable outcome measure.

Figures

Figure 1
Figure 1
Measurement of passive range of motion in shoulder. a) Abduction. b) External rotation. c) Internal rotation. d) Hand behind back.
Figure 2
Figure 2
Bland-Altman plot with mean abduction values for a) affected and b) non-affected arm in 50 patients with adhesive capsulitis at visit 1 for both testers plotted against the difference between testers. For the non-affected arm equal values are dispersed by a factor of 0.1 degrees at 90 degrees.

References

    1. Muir SW, Corea CL, Beaupre L. Evaluating change in clinical status: reliability and measures of agreement for the assessment of gleno-humeral range of motion. N Am J Sports Phys Ther. 2010;5:98–110.
    1. van der Windt DA, van der Heijden GJ, Scholten RJ, Koes BW, Bouter LM. The efficacy of non-steroidal anti-inflammatory drugs (NSAIDS) for shoulder complaints. A systematic review. J Clin Epidemiol. 1995;48:691–704. doi: 10.1016/0895-4356(94)00170-U.
    1. Green S, Buchbinder R, Glazier R, Forbes A. Interventions for shoulder pain. Cochrane Database of Syst Rev. 1999, Issue 2. Art. No.: CD001156. doi: 10.1002/14651858.CD001156.
    1. van der Heijden GJ, van der Windt DA, Kleijnen J, Koes BW, Bouter LM. Steroid injections for shoulder disorders: a systematic review of randomized clinical trials. Br J Gen Pract. 1996;46:309–316.
    1. Pal B, Anderson J, Dick WC, Griffiths ID. Limitation of joint mobility and shoulder capsulitis in insulin- and non-insulin-dependent diabetes mellitus. Br J Rheumatol. 1986;25:147–151. doi: 10.1093/rheumatology/25.2.147.
    1. Hannafin JA, Chiaia TA. Adhesive capsulitis. A treatment approach. Clin Orthop Relat Res. 2000;372:95–109. doi: 10.1097/00003086-200003000-00012.
    1. Bunker TD, Anthony PP. The pathology of frozen shoulder. A Dupuytren-like disease. J Bone Joint Surg Br. 1995;77:677–683.
    1. Riddle DL, Rothstein JM, Lamb RL. Goniometric reliability in a clinical setting: shoulder measurements. Phys Ther. 1987;67:668–673.
    1. MacDermid JC, Chesworth BM, Patterson S, Roth JH. Intratester and intertester reliability of goniometric measurement of passive lateral shoulder rotation. J Hand Ther. 1999;12:187–192. doi: 10.1016/S0894-1130(99)80045-3.
    1. Hayes K, Walton JR, Szomor ZR, Murrell GA. Reliability of five methods for assessing shoulder range of motion. Aust J Physiother. 2001;47:289–294. doi: 10.1016/S0004-9514(14)60274-9.
    1. Kolber MJ, Vega F, Widmayer K, Cheng MS. The reliability and minimal detectable change of shoulder mobility measurements using a digital inclinometer. Physiother Theory Pract. 2011;27:176–184. doi: 10.3109/09593985.2010.481011.
    1. Nadeau S, Kovacs S, Gravel D, Piotte F, Moffet H, Gagnon D, et al. Active movement measurements of the shoulder girdle in healthy subjects with goniometer and tape measure techniques: a study on reliability and validity. Physiother Theory Pract. 2007;23:179–187. doi: 10.1080/09593980701209246.
    1. Mullaney MJ, McHugh MP, Johnson CP, Tyler TF. Reliability of shoulder range of motion comparing a goniometer to a digital level. Physiother Theory Pract. 2010;26:327–333. doi: 10.3109/09593980903094230.
    1. Sabari JS, Maltzev I, Lubarsky D, Liszkay E, Homel P. Goniometric assessment of shoulder range of motion: comparison of testing in supine and sitting positions. Arch Phys Med Rehabil. 1998;79:647–651. doi: 10.1016/S0003-9993(98)90038-7.
    1. Tveita EK, Ekeberg OM, Juel NG, Bautz-Holter E. Range of shoulder motion in patients with adhesive capsulitis; intra-tester reproducibility is acceptable for group comparisons. BMC Musculoskelet Disord. 2008;9:49. doi: 10.1186/1471-2474-9-49.
    1. Green S, Buchbinder R, Forbes A, Bellamy N. A standardized protocol for measurement of range of movement of the shoulder using the Plurimeter-V inclinometer and assessment of its intrarater and interrater reliability. Arthritis Care Res. 1998;11:43–52. doi: 10.1002/art.1790110108.
    1. de Winter AF, Heemskerk MA, Terwee CB, Jans MP, Deville W, van Schaardenburg DJ, et al. Inter-observer reproducibility of measurements of range of motion in patients with shoulder pain using a digital inclinometer. BMC Musculoskelet Disord. 2004;5:18. doi: 10.1186/1471-2474-5-18.
    1. de Vet HCW, Terwee CB, Mokkink LB, Knol DL. Measurements in Medicine. Cambridge, U.K: Cambridge University Press; 2011. pp. 126–128.
    1. Pandya S, Florence JM, King WM, Robison JD, Oxman M, Province MA. Reliability of goniometric measurements in patients with duchenne muscular dystrophy. Phys Ther. 1985;65:1339–1342.
    1. Terwee CB, de Winter AF, Scholten RJ, Jans MP, Devillé W, van Schaardenburg D, et al. Interobserver reproducibility of the visual estimation of range of motion of the shoulder. Arch Phys Med Rehabil. 2005;86:1356–1361. doi: 10.1016/j.apmr.2004.12.031.
    1. Croft P, Pope D, Boswell R, Rigby A, Silman A. Observer variability in measuring elevation and external rotation of the shoulder. Primary Care Rheumatology Society Shoulder Study Group. Br J Rheumatol. 1994;33:942–946. doi: 10.1093/rheumatology/33.10.942.
    1. Hoving JL, Buchbinder R, Green S, Forbes A, Bellamy N, Brand C, et al. How reliably do rheumatologists measure shoulder movement? Ann Rheum Dis. 2002;61:612–616. doi: 10.1136/ard.61.7.612.
    1. Awan R, Smith J, Boon AJ. Measuring shoulder internal rotation range of motion: a comparison of 3 techniques. Arch Phys Med Rehabil. 2002;83:1229–1234. doi: 10.1053/apmr.2002.34815.
    1. de Jong LD, Dijkstra PU, Stewart RE, Postema K. Repeated measurements of arm joint passive range of motion after stroke: interobserver reliability and sources of variation. Phys Ther. 2012;92:1027–1035. doi: 10.2522/ptj.20110280.
    1. Dias R, Cutts S, Massoud S. Frozen shoulder. BMJ. 2005;331:1453–1456. doi: 10.1136/bmj.331.7530.1453.
    1. Nagy MT, Macfarlane RJ, Khan Y, Waseem M. The frozen shoulder: myths and realities. Open Orthop J. 2013;7:352–355. doi: 10.2174/1874325001307010352.
    1. Watson L, Balster SM, Finch C, Dalziel R. Measurement of scapula upward rotation: a reliable clinical procedure. Br J Sports Med. 2005;39:599–603. doi: 10.1136/bjsm.2004.013243.
    1. Ginn KA, Cohen ML, Herbert RD. Does hand-behind-back range of motion accurately reflect shoulder internal rotation? J Shoulder Elbow Surg. 2006;15:311–314. doi: 10.1016/j.jse.2005.08.005.
    1. Wakabayashi I, Itoi E, Minagawa H, Kobayashi M, Seki N, Shimada Y, et al. Does reaching the back reflect the actual internal rotation of the shoulder? J Shoulder Elbow Surg. 2006;15:306–310. doi: 10.1016/j.jse.2005.08.022.
    1. Eliasziw M, Young SL, Woodbury MG, Fryday-Field K. Statistical methodology for the concurrent assessment of interrater and intrarater reliability: using goniometric measurements as an example. Phys Ther. 1994;74:777–788.
    1. Bland JM, Altman DG. Measurement error. BMJ. 1996;312:1654. doi: 10.1136/bmj.312.7047.1654.
    1. Stokes EK. Rehabilitation outcome measures. 1. Edinburgh; New York: Churchill Livingstone; 2011. pp. 27–32.
    1. Musselman K. Clinical significance testing in rehabilitation research: what, why, and how? Phys Ther Rev. 2007;12:287–296. doi: 10.1179/108331907X223128.
    1. Ombregt L, Bisschop P, Veer HJ, Van de Velde T. A System of orthopaedic medicine. London: Saunders; 1995.
    1. Shaffer B, Tibone JE, Kerlan RK. Frozen shoulder. A long-term follow-up. J Bone Joint Surg Am. 1992;74:738–746.
    1. Gajdosik RL, Bohannon RW. Clinical measurement of range of motion: review of goniometry emphasizing reliability and validity. Phys Ther. 1987;67:1867–1872.
    1. Fish DR, Wingate L. Sources of goniometric error at the elbow. Phys Ther. 1985;65:1666–1670.

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