At inclusion, participants in our study were patients with moderate to severe capsulitis. The numerical pain rating scale NPRS ranged from 5 to 9, which characterizes moderate to severe pain and may pose problems in measuring ROM. However, the very good to excellent reliability proves otherwise, i.
The pre-treatment value for pain and function indicated moderate to severe problems SPADI values varied from 42 to 98, on average We chose to only examine passive ABD, ER, IR and HBB as these are the standard movements for diagnosis of shoulder capsulitis and may also be used over time to monitor progression [ 34 , 35 ]. Since pain and stiffness pose particular problems while measuring PROM, for example in finding out the exact end point of movement, measurement of AROM could have been a good supplement.
Joint Range of Motion Study
The strength of this study lies in its good power, representativeness of the condition studied and good to excellent results, as well as being the first study that measures intertester reliability in patients with shoulder adhesive capsulitis with plurimeter. Among limitations it may be mentioned that non-randomization of testers may have induced systematic measurement error, as tester 2 may have provoked pain and thus affected the PROM for tester 1.
The testers had two criteria, pain and stiffness, for judging the end of movement and this may also have constituted some source of measurement variation, although small.
Despite the non-randomised test-procedure our results are very good. Although tester 2, who always tested before tester 1, had a tendency to measure a larger range for external and internal rotation, and mostly for the non-affected arm, findings in our study show an overall very good to excellent reliability for measuring PROM in patients with this condition. This is an important finding because measuring PROM is the diagnostic test for adhesive shoulder capsulitis. Little difference in intertester reliability occurred for the duration of the study eight weeks. Although an intra-tester reliability study with short time intervals was not performed, our results indicate that we can trust the measurements from one tester at different visits also in an effect study.
Sincere thanks to Nils Ivar Aanes for being the blinded tester. A grant was also received from Dr. Competing interests. All authors contributed to the design of the study. SS recruited the patients, measured range of motion and drafted the manuscript, performed statistical analysis with help from AK.
AK and AB helped in drafting the manuscript. All authors have read and approved the final manuscript. Satya Pal Sharma, Email: on. National Center for Biotechnology Information , U.
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BMC Musculoskelet Disord. Published online Feb Author information Article notes Copyright and License information Disclaimer.
Corresponding author. Received Dec 2; Accepted Feb This article has been cited by other articles in PMC. Abstract Background Measuring range of motion ROM in the shoulder joint is important for the diagnosis and monitoring of change over time. Methods Fifty patients with a clinical diagnosis of adhesive shoulder capsulitis were examined by two independent testers. Results Very good to excellent intertester agreements were found for most parameters for the affected arm at all three test points.
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. Keywords: Adhesive capsulitis, Reliability, Passive range of motion, Plurimeter.
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Background Range of motion ROM in the shoulder joint is among the commonly used clinical criteria for diagnostic purposes and to monitor effectiveness of given treatment [ 1 ]. Table 1 Summary of intra- and intertester reliability studies for range of motion on both the affected and the non-affected shoulders using different measuring modalities. IR without scap.
Open in a separate window. With few exceptions only the inter-tester ICC values are written in the table. Methods PROM in the shoulder joint is defined as to the extent an investigator can move the arm until pain or stiffness limits the movement. Participants Patients potentially eligible for inclusion in the randomized controlled trial for treatment of shoulder capsulitis were referred to a primary care clinic by physicians and physiotherapists in the period — Testers Both testers were experienced general practitioners and had experience with measurements of shoulder movements with goniometer from a former pilot study.
In standing Passive gleno-humeral abduction ABD The patient was in standing position and the tester stood partly behind and partly to the side of the patient to be measured. Statistics Descriptive statistics with mean measurement including standard deviation SD for each movement is presented. Table 2 Mean range and standard deviation SD for two testers for abduction ABD in 50 patients with shoulder capsulitis.
ABD non-affected Table 3 Mean range and standard deviation SD for two testers for external rotation ER in 50 patients with shoulder capsulitis. ER non-affected Table 4 Mean range and standard deviation SD for two testers for internal rotation IR and hand behind back HBB in 50 patients with shoulder capsulitis. IR non-affected Table 5 Mean range and standard deviation SD for two testers for hand behind back HBB in 50 patients with shoulder capsulitis. HBB non-affected cm Figure 2. Discussion This large cohort study demonstrated very good to excellent intertester reliability when examining PROM in patients with shoulder adhesive capsulitis stage II.
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Conclusion 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. Acknowledgements Sincere thanks to Nils Ivar Aanes for being the blinded tester. Footnotes Competing interests The authors declare that they have no competing interests. References 1.
Evaluating change in clinical status: reliability and measures of agreement for the assessment of gleno-humeral range of motion. A systematic review. J Clin Epidemiol. Interventions for shoulder pain. Cochrane Database of Syst Rev.
Steroid injections for shoulder disorders: a systematic review of randomized clinical trials. Br J Gen Pract. Limitation of joint mobility and shoulder capsulitis in insulin- and non-insulin-dependent diabetes mellitus. Br J Rheumatol. Adhesive capsulitis. A treatment approach. Clin Orthop Relat Res. The pathology of frozen shoulder. A Dupuytren-like disease. J Bone Joint Surg Br. Goniometric reliability in a clinical setting: shoulder measurements. Phys Ther. Intratester and intertester reliability of goniometric measurement of passive lateral shoulder rotation.
J Hand Ther.
Range of Motion Terminology
Reliability of five methods for assessing shoulder range of motion. Aust J Physiother. The reliability and minimal detectable change of shoulder mobility measurements using a digital inclinometer. The shoulder joint has the following normal ranges of movement: Flexion, Extension, Adduction, Abduction and Medial Rotation.
The elbow joint has the following normal ranges of movement: Flexion, Extension, Pronation and Supination. The wrist joint has the following normal ranges of movement: Flexion, Extension, Adduction, Abduction and Circumduction. The knee joint has the following normal ranges of movement: Flexion and Extension.
UK: The Crowood Press. Active range of motion exercises — These exercises involve very little assistance from the physical therapist. They are most useful in cases of minor injuries that do not severely restrict the movement of body parts, but are painful, uncomfortable, or hindering nevertheless. Pro tip 1: If are looking for more information on the benefits of physical therapy see out other blog post. Pro tip 2: If your interested in learning about the different types of physical therapy see our post here.
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