Intertester reliability of a movement impairment-based classification system for individuals with shoulder pain.
Patitta Torwichien, Mantana Vongsirinavarat, Prasert Sakulsriprasert and 1 others
PMID 32489240WHAT IT FOUND
Two trained physical therapists did not always classify shoulder pain the same way using the Movement System Impairment system.
They agreed on broad syndromes 71.11% of the time, and detailed patterns were less consistent.
Key findings
01Two examiners agreed on broad syndrome in 71.11% of cases, with fair chance-corrected agreement (K=0.34).
02Scapular depression and humeral superior glide had substantial agreement (K=0.64 and 0.66).
03Overall agreement across the detailed subcategory syndromes was slight (K=0.112).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 45 patients were included, and they were recruited by convenience sampling, so the agreement may not apply to other clinics or patient groups. All patients were classified as having movement impairment, so the study could not test agreement for identifying patients without impairment. Some categories had very few or no patients, including scapular elevation and humeral medial rotation, so chance-corrected agreement could not be calculated for them. The same patients were examined twice on the same day, and repeated testing may change symptoms or movement responses. Most participants had mild to moderate pain and disability, so results may not apply to patients with severe symptoms. The two examiners had different experience and had not been trained by the approach developer, so agreement may depend on training level.
Declared interests
The authors declared no conflict of interest, and the study received no grant from public, commercial, or not-for-profit funding agencies.
The easy way to misread this
Do not conclude that the shoulder MSI classification is ready to guide treatment because two individual patterns had substantial agreement. The overall detailed pattern agreement was slight (K=0.112), and broad syndrome agreement was only fair (K=0.34).