A STANDARDIZED PROTOCOL FOR MEASUREMENT OF RANGE OF MOVEMENT OF THE SHOULDER USING THE PLURIMETER-V INCLINOMETER AND ASSESSMENT OF ITS INTRARATER AND INTERRATER RELIABILITY

Objective. To develop a standardized protocol for measurement of shoul der movements using a gravity inclinometer designed for use in clinica l trials, and to assess its intra- and interrater reliability in a gro up of manipulative physiotherapists. Methods. After instruction, 6 man ipulative physiotherapists independently assessed 8 movements of the s houlder, including total and glenohumeral flexion (TF, GHF), total and glenohumeral abduction (TA, GHA), external rotation in neutral (ERN) and abduction (ERA), internal rotation in abduction (IRA), and hand be hind back (HBB), in random order in 6 patients with shoulder pain and stiffness according to a 6 X 6 Latin square design using the standardi zed protocol. The assessments were then repeated. Analysis of variance was used to partition total variability into components of variance i n order to calculate intraclass correlation coefficients (ICCs). Resul ts. The intra- and interrater reliability of the different movements v aried widely. Reliability was higher for TF and TA than for the corres ponding glenohumeral movements (e.g., intrarater ICCs: TF = 0.80, GHF = 0.65, TA = 0.75, GHA = 0.62). Interrater reliability was higher in t he second round suggesting a practice effect (e.g., round 1,2 interrat er ICCs TF = 0.62, 0.82; TA = 0.62, 0.88; ERN = 0.85, 0.95). Conclusio n. The measurement of the active range of TF, TA, ERN, and HBB, measur ed by manipulative physiotherapists following the standardized protoco l, has intra- and interrater reliability acceptable for use as an outc ome measure in clinical trials assessing interventions for shoulder pa in.