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  • Reliability of specific physical examination tests for the diagnosis of shoulder pathologies: a systematic review and meta-analysis

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Review
Reliability of specific physical examination tests for the diagnosis of shoulder pathologies: a systematic review and meta-analysis
  1. Toni Lange1,
  2. Omer Matthijs2,3,
  3. Nitin B Jain4,
  4. Jochen Schmitt1,
  5. Jörg Lützner5,
  6. Christian Kopkow1,6
  1. 1Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
  2. 2Texas Tech University, School of Health Professions, Lubbock, Texas, USA
  3. 3International Academy of Orthopedic Medicine—Europe, Stuttgart, Germany
  4. 4Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  5. 5Department of Orthopaedic and Trauma Surgery, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
  6. 6Department für Angewandte Gesundheitswissenschaften, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
  1. Correspondence to Professor Christian Kopkow, Department für Angewandte Gesundheitswissenschaften, Hochschule für Gesundheit (University of Applied Sciences), Gesundheitscampus 6–8, Bochum 44801, Germany; Christian.Kopkow{at}hs-gesundheit.de

Abstract

Background Shoulder pain in the general population is common and to identify the aetiology of shoulder pain, history, motion and muscle testing, and physical examination tests are usually performed.

Objective The aim of this systematic review was to summarise and evaluate intrarater and inter-rater reliability of physical examination tests in the diagnosis of shoulder pathologies.

Methods A comprehensive systematic literature search was conducted using MEDLINE, EMBASE, Allied and Complementary Medicine Database (AMED) and Physiotherapy Evidence Database (PEDro) through 20 March 2015. Methodological quality was assessed using the Quality Appraisal of Reliability Studies (QAREL) tool by 2 independent reviewers.

Results The search strategy revealed 3259 articles, of which 18 finally met the inclusion criteria. These studies evaluated the reliability of 62 test and test variations used for the specific physical examination tests for the diagnosis of shoulder pathologies. Methodological quality ranged from 2 to 7 positive criteria of the 11 items of the QAREL tool.

Conclusions This review identified a lack of high-quality studies evaluating inter-rater as well as intrarater reliability of specific physical examination tests for the diagnosis of shoulder pathologies. In addition, reliability measures differed between included studies hindering proper cross-study comparisons.

Trial registration number PROSPERO CRD42014009018.

  • Shoulder
  • Review
  • Reliability

https://doi.org/10.1136/bjsports-2016-096558

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    Footnotes

    • Contributors TL made a substantial contribution to the design of the study; performed the literature search; reviewed the literature; methodologically appraised the articles; extracted, analysed and interpreted the data; produced the figures and graphs; critically revised and wrote the manuscript. OM and NBJ assisted with analysis and interpretation of data; critically revised the article and wrote the manuscript. JS and JL critically commented on the design of the study; and critically revised the manuscript. CK made a substantial contribution to the design of the study; reviewed the literature; methodologically appraised the articles; extracted the data in duplicate; analysed and interpreted the data; and critically revised and wrote the manuscript.

    • Funding NBJ is supported by funding from National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) 1K23AR059199.

    • Competing interests None declared.

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