title: Construct validity of Cyriax's selective tension examination: association of end-feels with pain at the knee and shoulder.
abstract: METHODS
  Descriptive.
  
  
  OBJECTIVE
  To examine the relationship between pain and normal and abnormal-pathologic end-feels during passive physiologic motion assessment at the knee and shoulder. We theorized that abnormal-pathologic end-feels would be more painful than normal end-feels.
  
  
  BACKGROUND
  End-feel testing and pain intensity information are part of physical therapy musculoskeletal patient examinations. End-feels are categorized as normal or abnormal-pathologic. No previous studies have examined the relationship between pain during end-feel testing and the type of end-feel.
  
  
  METHODS
  Two physical therapists examined subjects with unilateral knee or shoulder pain. Each subject was examined twice. Passive physiologic motions, 2 at the knee and 5 at the shoulder, were tested by applying an overpressure at the end of range of motion using standardized positions. Subjects reported the amount of pain (0-10) immediately after the evaluator recorded the end-feel. Analyses included one-way ANOVAs and post-hoc Tukey's Honestly Significant Difference tests.
  
  
  RESULTS
  Some abnormal-pathologic end-feels were significantly more painful than the normal end-feels at both the knee and the shoulder for all physiologic motions. Among the abnormal-pathologic end-feel categories there were no statistical differences in pain intensity, although small samples in some categories may be responsible for this finding.
  
  
  CONCLUSIONS
  Abnormal-pathologic end-feels are associated with more pain than normal end-feels during passive physiologic motion testing at the knee or shoulder. Dysfunction should be suspected when abnormal-pathologic end-feels are present.
authors.affiliation: Department of Physical Therapy and Human Movement Sciences, Northwestern University Medical School, Chicago, Ill, USA. c-petersen@nwu.edu
authors.forename: C M
authors.initials: CM
authors.lastname: Petersen
authors.forename: K W
authors.initials: KW
authors.lastname: Hayes
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D007717:Knee; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010146:Pain / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology*; D010147:Pain Measurement / Q000379:methods*; D010173:Palpation / Q000379:methods*; D026741:Physical Therapy Modalities / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology*; D012782:Shoulder