Abstract
Study Design
Systematic review.
Introduction
Physiotherapists routinely assess the position of the humeral head (HH) in patients
with shoulder pain.
Purpose of the Study
To conduct a systematic review to determine the quality and content of studies that
evaluated the reliability of clinical measurement methods for assessing the HH position.
Methods
Five databases and gray literature were searched for studies fitting the eligibility
criteria. After abstract and full-text review, the included studies were appraised
using the Quality Appraisal of Reliability Studies checklist. Articles were considered
of high quality if 8 was achieved on the checklist, and the overall quality of evidence
was classified using prespecified criteria. Multiple raters extracted and performed
quality ratings; a consensus process was used to finalize the reliability data that
were synthesized and presented in a narrative synthesis. Reliability was classified
as excellent if the intracorrelation coefficients or intercorrelation coefficients
(ICCs) reported exceeded 0.75.
Results
Fifteen studies on the reliability of ultrasound (US) and 3 studies on palpation were
included. The methodologic quality was moderate in 17 of 18 studies. The intrarater
reliability for all studies was excellent (ICC, 0.76-0.99) with the exception of the
90° abduction in internal rotation position (ICC, 0.48) for palpation. The inter-rater
reliability tended to be lower (ICC, 0.48-0.68) for palpation and higher (ICC, 0.66-0.99)
for US. Physiotherapists demonstrated excellent intrarater reliability across different
levels of training in ultrasonography.
Discussion
Our study found a moderate overall level of evidence to support the use of US for
assessing HH position in symptomatic or asymptomatic subjects.
Conclusion
A moderate overall level of evidence exists for the use of US to reliably assess the
HH position. Limited research supports the methods used for palpation within a clinical
setting.
Level of Evidence
2a.
Keywords
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JHT Read for Credit
Quiz: #503
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- #1.The study design is
- a.a prospective cohort
- b.RCTs
- c.qualitative
- d.a systematic review
- a.
- #2.The purpose of the investigation was to determine the _______________of clinical tests for humeral head position
- a.most common application
- b.correlation to X-ray findings
- c.reliability
- d.validity
- a.
- #3.The palpation method was based on comparing the distance between the _________________________ in the involved limb to that same measure in the uninvolved limb
- a.anterior acromion and the anterior humeral head
- b.anterior acromion and the bicipital groove
- c.anterior humeral head and the scapular notch
- d.anterior humeral head and the A/C joint
- a.
- #4.The reliability was
- a.greater for inter-rater than intra-rater
- b.greater for intra-rater than inter-rater
- c.the same for intra-rater and inter-rater
- d.none of the above
- a.
- #5.Conclusive evidence was found for the use of both methods, ultra sound and palpation
- a.true
- b.false
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Published online: August 09, 2017
Accepted:
June 15,
2017
Received in revised form:
April 24,
2017
Received:
November 28,
2016
Identification
Copyright
© 2017 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.
