title: Inter-rater reliability for measurement of passive physiological range of motion of upper extremity joints is better if instruments are used: a systematic review.
abstract: OBJECTIVE
  What is the inter-rater reliability for measurements of passive physiological or accessory movements in upper extremity joints?
  
  
  METHODS
  Systematic review of studies of inter-rater reliability.
  
  
  METHODS
  Individuals with and without upper extremity disorders.
  
  
  METHODS
  Range of motion and end-feel using methods feasible in clinical practice.
  
  
  RESULTS
  Twenty-one studies were included of which 11 demonstrated acceptable inter-rater reliability. Two studies satisfied all criteria for internal validity while reporting almost perfect reliability. Overall, the methodological quality of studies was poor. ICC ranged from 0.26 (95% CI -0.01 to 0.69) for measuring the physiological range of shoulder internal rotation using vision to 0.99 (95% CI 0.98 to 1.0) for the physiological range of finger and thumb flexion/extension using a goniometer. Measurements of physiological range of motion using instruments were more reliable than using vision. Measurements of physiological range of motion were also more reliable than measurements of end-feel or of accessory range of motion.
  
  
  CONCLUSIONS
  Inter-rater reliability for the measurement of passive movements of upper extremity joints varies with the method of measurement. In order to make reliable decisions about joint restrictions in clinical practice, we recommend that clinicians measure passive physiological range of motion using goniometers or inclinometers.
authors.affiliation: Private Practice Physiotherapy, The Hague, The Netherlands.
authors.forename: Rachel J
authors.initials: RJ
authors.lastname: van de Pol
authors.forename: Emiel
authors.initials: E
authors.lastname: van Trijffel
authors.forename: Cees
authors.initials: C
authors.lastname: Lucas
mesh_terms: D053587:Arthrometry, Articular / Q000295:instrumentation*; D001696:Biomechanical Phenomena; D006801:Humans; D026741:Physical Therapy Modalities / Q000295:instrumentation*; D015203:Reproducibility of Results; D034941:Upper Extremity / Q000502:physiology*