title: Inter-rater reliability of shoulder measurements in middle-aged women.
abstract: OBJECTIVE
  To investigate inter-rater reliability of a set of shoulder measurements including inclinometry [shoulder range of motion (ROM)], acromion-table distance and pectoralis minor muscle length (static scapular positioning), upward rotation with two inclinometers (scapular kinematics) and pain pressure thresholds (muscle tenderness) in middle-aged women.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Thirty symptom-free middle-aged women (first cohort) were measured by two raters. All measurements with an intraclass correlation coefficient (ICC) below 0.75 were retested after an additional training period in a second cohort of 30 symptom-free middle-aged women.
  
  
  METHODS
  Inter-rater reliability of all variables was measured with the ICC (95% confidence interval) and standard error of measurement (SEM).
  
  
  RESULTS
  Acromion-table distance (ICC=0.91, SEM 0.22 to 0.28% of body length), pectoralis minor muscle length (ICC=0.91, SEM 0.16% of body length), pain pressure thresholds (ICC=0.78 to 0.85, SEM 0.39 to 0.70kg) and abduction ROM (ICC=0.77, SEM 5°) showed good to excellent inter-rater reliability in the first cohort. After an additional training period, forward flexion ROM showed good inter-rater reliability (ICC=0.83, SEM 5°), scapular upward rotation in resting position showed moderate reliability (ICC=0.52, SEM 2°), and other scaption angles showed weak reliability (ICC=0.26 to 0.43, SEM 3 to 8°).
  
  
  CONCLUSIONS
  In a battery of clinical tools to evaluate factors contributing to shoulder pain, static scapular positioning and pressure pain thresholds were found to have good to excellent inter-rater reliability in middle-aged women. Additional training is recommended for measurements with a gravity inclinometer.
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium; Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium. Electronic address: an.degroef@faber.kuleuven.be.
authors.forename: A
authors.initials: A
authors.lastname: De Groef
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium; Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Van Kampen
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium; Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Vervloesem
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium; Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Clabau
authors.affiliation: Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium; Department of Surgical Oncology, KU Leuven - University of Leuven, Leuven, Belgium.
authors.forename: M-R
authors.initials: MR
authors.lastname: Christiaens
authors.affiliation: Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium; Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Neven
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium; Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium.
authors.forename: I
authors.initials: I
authors.lastname: Geraerts
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerp, Belgium.
authors.forename: F
authors.initials: F
authors.lastname: Struyf
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium; Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Devoogdt
mesh_terms: D000174:Acromion / Q000033:anatomy & histology*; D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D017288:Pain Threshold; D010369:Pectoralis Muscles / Q000033:anatomy & histology*; D026741:Physical Therapy Modalities / Q000592:standards*; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D012785:Shoulder Joint / Q000033:anatomy & histology*
keywords: Algometry; Inclinometry; Inter-rater reliability; Static scapular positioning