Measuring subluxation of the hemiplegic shoulder: reliability of a method.
OBJECTIVE
Subluxation of the shoulder after stroke can be measured according to the method described by Van Langenberghe and Hogan.


METHODS
To evaluate the reliability of this method, the shoulder radiographs of 25 patients were available for this study. Two independent raters each assessed these radiographs twice.


RESULTS
The intrarater reliability was good: percentage of agreement was 88 and 84%, weighted kappa, 0.69 [95% confidence interval (CI), 0.38-1.0] and 0.78 (95% CI, 0.60-0.95) for raters 1 and 2, respectively. The interrater reliability was poor: percentage of agreement was 36 and 28%, kappa, 0.11 (95% CI, 0.0-0.31) and 0.09 (95% CI, 0.0-0.23) in sessions 1 and 2, respectively. Subsequently the original method was adjusted by combining two categories (no subluxation and beginning subluxation) into one ("no clinically important subluxation").


CONCLUSIONS
After this adjustment of the categories, the interrater reliability improved [percentage of agreement, 72%, and kappa, 0.49 (95% CI, 0.18-0.80)], but did not reach acceptable values.
Snels
I A
IA
Department of Rehabilitation Medicine, University Hospital, and Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands.
Beckerman
H
H
ten Kate
J J
JJ
Lankhorst
G J
GJ
Bouter
L M
LM
D000368:Aged; D000369:Aged, 80 and over; D001175:Arthrography / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006429:Hemiplegia / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010146:Pain / Q000000981:diagnostic imaging; D015203:Reproducibility of Results; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging* / Q000209:etiology; D012785:Shoulder Joint / Q000000981:diagnostic imaging; D020521:Stroke / Q000150:complications / Q000000981:diagnostic imaging*