Intrarater and interrater reliability of three isometric dynamometers in assessing shoulder strength (original) (raw)
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Reliability of 3 methods for assessing shoulder strength
Journal of Shoulder and Elbow Surgery, 2002
The reliability of tests for isometric strength of the shoulder joint in symptomatic subjects has yet to be established. For this purpose, interrater and intrarater agreement trials were undertaken to ascertain the reliability of manual muscle tests, a handheld dynamometer, and a springscale dynamometer for 5 different shoulder movements in symptomatic subjects. Intraclass correlation coefficients were calculated from a random-effects model. All movements tested with the handheld dynamometer demonstrated excellent reliability for the interrater trial (ρ = 0.79-0.92). Excellent reliability was also demonstrated for elevation, external rotation, and internal rotation for the intrarater trial (ρ = 0.79-0.96). For the interrater trial, measurement of the lift-off maneuver with the handheld dynamometer was significantly more reliable than with manual muscle tests (P = .002). In summary, the handheld dynamometer was the most reliable and discriminatory means for assessing strength of the rotator cuff in symptomatic subjects.
Inter-rater and intra-rater reliability of a movement control test in shoulder
2017
BACKGROUND Movement faults are commonly observed in patients with musculoskeletal pain. The Kinetic Medial Rotation Test (KMRT) is a movement control test used to identify movement faults of the scapula and gleno-humeral joints during arm movement. Objective tests such as the KMRT need to be reliable and valid for the results to be applied across different clinical settings and patient populations. The primary objective of the present study was to determine the intra-rater and inter-rater reliability of KMRT in subjects with and without shoulder pain. METHODS Sixty subjects were included in this study based on specific inclusion and exclusion criteria. Two musculoskeletal physiotherapists with different levels of clinical experience performed the tests. The intra-rater reliability was tested in twenty asymptomatic subjects by a single assessor at two week intervals. An equal number of subjects with and without shoulder pain were tested by both the assessors to determine the inter-ra...
International Journal of Environmental Research and Public Health
The purpose of this study is to establish the absolute reliability between hand-held dynamometers (HHDs) and concurrent validity between HHDs and isokinetic dynamometers (IDs) in shoulder rotator strength assessment. The Medline, CINAHL, and Central databases were searched for relevant studies up to July 2020. Absolute reliability was determined by test–retest studies presenting standard error of measurement (SEM%) and/or minimal detectable change (MDC%) expressed as percentage of the mean. Studies considering intra-class correlation coefficient (ICC) between IDs and HHDs were considered for concurrent validity. The risk of bias and the methodological quality were evaluated according to COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Thirteen studies were included in the meta-analysis. Shoulder internal rotator strength assessment MDC% was 0.78%, 95% confidence interval (CI) −5.21 to 3.66, while shoulder external rotators MDC% was 3.29%, CI −2...
International Journal of Environmental Research and Public Health
This study determined the intra- and inter-rater reliability of various shoulder testing methods to measure flexion range of motion (ROM), hand-behind-back (HBB), and external rotation (ER) strength. Twenty-four healthy adults (mean age of 31.2 and standard deviation (SD) of 10.9 years) without shoulder or neck pathology were assessed by two examiners using standardised testing protocols to measure shoulder flexion with still photography, HBB with tape measure, and isometric ER strength in two abduction positions with a hand-held dynamometer (HHD) and novel stabilisation device. Intraclass correlation coefficient (ICC) established relative reliability. Standard error of measurement (SEM) and minimum detectable change (MDC) established absolute reliability. Differences between raters were visualised with Bland–Altman plots. A paired t-test assessed for differences between dominant and non-dominant sides. Still photography demonstrated good intra- and inter-rater reliability (ICCs 0.7...
Reliability of shoulder rotators isokinetic strength imbalance measured using the Biodex dynamometer
Journal of Science and Medicine in Sport, 2013
Background: Isokinetic assessment of shoulder internal and external rotators is commonly used by clinicians to assess muscle performance and to guide rehabilitation. The reliability of isokinetic assessment is fundamental to track small but clinically relevant changes. Objectives: We aimed to analyze the absolute and relative reliability of strength imbalance indices such as peak torque ratios (ERconc/IRconc, ERecc/IRecc, ERecc/IRcon, IRecc/ERcon), bilateral concentric and eccentric strength ratios, and to examine the reliability of external rotator and internal rotator peak torque measured using a Biodex ® dynamometer in the seated position. Design: Cross-sectional laboratory study. Methods: Forty-six healthy participants were tested twice with seven days between sessions, at 60 • /s and 120 • /s concentrically, and 30 • /s eccentrically. Results: Low to moderate relative reliability (intraclass correlation coefficient: 0.25-0.81) was found for unilateral and bilateral strength imbalance ratios. High intraclass correlation coefficient values (0.87-0.97) were found for peak torque. Concerning absolute reliability, the standard error of measurement ranged from 9.1 to 25.6% for strength imbalance ratios and from 7.7 to 14.5% for peak torque measurements, and minimal detectable change ranged from 25.2 to 71% for strength imbalance ratios and from 21.3 to 40.2% for peak torque measurements. Conclusions: The standard error of measurement and minimal detectable change reported in the present study should be taken into account when evaluating the individual longitudinal changes in clinical practice.
Human Movement
Purpose. To determine the validity, intra-rater reliability, and inter-rater reliability of an anchored sphygmomanometer for assessing shoulder strength during scaption, lateral rotation, and medial rotation. The hand-held dynamometer (HHD) was used as the standard measurement tool for this purpose. Methods. Fifty subjects (23 years old ±3 years) were included in the validity study. shoulder strength was assessed using an HHD and a sphygmomanometer, both anchored to a fixed ladder by an inextensible belt. Twenty-three subjects (25 years old ±3 years) were included in the reliability study. Two raters assessed strength, each taking two measurements one week apart, using the fixed sphygmomanometer. Results. Validity results showed high to very high magnitude correlations, and no differences were found between the sphygmomanometer and the HHD measurements or among trials. Intra-class coefficient of correlation (Icc) showed high reliability between measurement tools and among trials. Intra-rater results showed very high Icc, very high correlation, low coefficient of variation (cV) with adequate standard error of measurement (sEM), and minimal detectable change (MDc). Inter-rater results showed moderate to high Icc, high to very high correlation, acceptable sEM and cV, but not adequate MDc. The anchored sphygmomanometer is a low-cost tool that provides objective measurements. The results obtained from the anchored sphygmomanometer were found to be similar to those obtained from an HHD, which has a valid predictive model. Conclusions. The sphygmomanometer is suitable for monitoring shoulder strength during scaption, internal rotation, and external rotation. The anchored sphygmomanometer enables coaches and physical therapists to establish the maximal voluntary isometric contraction and monitor exercise program outcomes at a low cost. However, caution is recommended when interpreting results between raters.
Journal of Sport Rehabilitation, 2016
Context: The reliable measurement of shoulder strength is important when assessing athletes involved in overhead activities. Swimmers' shoulders are subject to repetitive humeral elevation and consequently have a high risk of developing movement-control issues and pain. Shoulder-strength tests performed in positions of elevation assist with the detection of strength deficits that may affect injury and performance. The reliability of isometric strength tests performed in positions of humeral elevation without manual stabilization, which is a typical clinical scenario, has not been established. Objective: To establish the relative and absolute intrarater reliability of shoulder-strength tests functional to swimming in 3 body positions commonly used in the clinical setting. Design: Repeated-measures reliability study. Setting: Research laboratory. Subjects: 15 university students and staff (mean ± SD age 24 ± 8.2 y). Intervention: Isometric shoulder-strength tests were performed in positions of humeral elevation (flexion and extension in 140° abduction in the scapular plane, internal and external rotation in 90° abduction) on subjects without shoulder pain in supine, prone, and sitting. Subjects were tested by 1 examiner with a handheld dynamometer and retested after 48 h. Main Outcome Measures: Relative reliability (ICC 3,1) values with 95% CI. Absolute reliability was reported by minimal detectable change (MDC). Results: Good to excellent intrarater reliability was found for all shoulder-strength tests (ICC .87-.99). Intrarater reliability was not affected by body position. MDC% was <16% for every test and ≤11% for tests performed in supine. Conclusions: Shoulder flexion, extension, and internal-and external-rotation strength tests performed in humeral elevation demonstrated excellent to good intrarater reliability regardless of body position. A strength change of more than 15% in any position can be considered meaningful.
Reliability of a new hand-held dynamometer in measuring shoulder range of motion and strength
Manual Therapy, 2011
Acceptable reliability is a prerequisite for inclusion of physical examination tests in clinical examinations of the painful shoulder. The aim of this study was to establish the intraexaminer and interexaminer reliability of measures of shoulder range of motion (ROM) and muscle force using a new hand-held dynamometer with the ability to standardize overpressure force during passive ROM tests. Forty consecutive subjects with shoulder pain were recruited, and tests were performed by two physiotherapists. Tests included active ROM elevation, passive ROM glenohumeral abduction and external rotation and resisted abduction and external rotation. All tests demonstrated high levels of intraexaminer reliability (ICC 0.85e0.99; LOA 6e24 and 1.1e7.0 kg). Highest levels of interexaminer reliability reliability were observed for measures of active ROM flexion (ICC 0.88e0.95; LOA 14e22 ). Passive ROM tests demonstrated 'moderate e substantial' interexaminer reliability (ICC 0.45e0.62; LOA 25e34 ). The ICCs for resisted tests ranged from 0.68 to 0.84, and LOA ranged from 3.2 to 8.5 kg. Active ROM flexion demonstrated high levels of both intra-and interexaminer reliability. Measures of passive ROM and peak isometric force demonstrated acceptable levels of intraexaminer reliability.
Clinics in Shoulder and Elbow
Background: Scapular dyskinesis is considered a risk factor for the shoulder pain that may warrant screening for prevention. Clinicians of all experience screen scapular dyskinesis using the scapular dyskinesis test yes-no classification (Y-N), yet its reliability in asymptomatic individuals is unknown. We aimed to establish Y-N’s intra- and inter-reliability between students and expert physical therapists.Methods: We utilized a cross-sectional design using consecutive asymptomatic subjects. Six students and two experts rated 100 subjects using the Y-N. Cohen’s kappa (κ) and Krippendorff’s alpha (K-α) were calculated to determine intra- and inter-rater reliability.Results: Intra- and inter-rater values for experts were κ=0.92 (95% confidence interval [CI], 0.91–0.93) and 0.85 (95% CI, 0.84–0.87) respectively; students were κ=0.77 (95% CI, 0.75–0.78) and K-α=0.63 (95% CI, 0.58–0.67).Conclusions: The Y-N is reliable in detecting scapular dyskinesis in asymptomatic individuals regardle...