Agreement and reliability of a symptom modification test cluster for patients with subacromial pain syndrome

Sean P. Riley, Jason K. Grimes, Adri T. Apeldoorn, Riekie de Vet

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Objectives: To identify if a plausible theoretical construct exists for a test cluster in a group of patients with subacromial pain syndrome presenting with glenohumeral internal rotation deficit (GIRD); determine the intertester agreement and reliability of the proposed test cluster; determine if there are any meaningful relationships between the test cluster and the component tests for the entire sample; and determine if there are any differences in disability on the Dutch version of the shoulder pain and disability index between participants with a positive and negative test cluster. Methods: This study is a retrospective secondary analysis of data that were collected to determine the interrater agreement and reliability of clinical tests for assessment of patients with shoulder pain in primary care. Results: The test cluster total agreement and negative specific agreement was 87.8 and 90.4%, respectively. The prevalence-adjusted bias-adjusted kappa for the test cluster was substantial at 0.76. There were statistically significant meaningful relationships (≥0.50) between GIRD and the test cluster for Tester A (Phi = 0.71, p <.01) and Tester B (Phi = 0.82, p <.01). No differences in disability were identified between those with a positive and negative test cluster. Conclusion: The test cluster described in this study may be a reliable means of identifying a subgroup of patients with subacromial pain syndrome related to GIRD. Future research should look to validate this test cluster prospectively.

Original languageEnglish
Article numbere1842
JournalPhysiotherapy research international
Issue number3
Publication statusPublished - 1 Jul 2020


  • reproducibility of results
  • shoulder
  • shoulder impingement syndrome

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