title: Reliability of specific physical examination tests for the diagnosis of shoulder pathologies: a systematic review and meta-analysis.
abstract: BACKGROUND
  Shoulder pain in the general population is common and to identify the aetiology of shoulder pain, history, motion and muscle testing, and physical examination tests are usually performed.
  
  
  OBJECTIVE
  The aim of this systematic review was to summarise and evaluate intrarater and inter-rater reliability of physical examination tests in the diagnosis of shoulder pathologies.
  
  
  METHODS
  A comprehensive systematic literature search was conducted using MEDLINE, EMBASE, Allied and Complementary Medicine Database (AMED) and Physiotherapy Evidence Database (PEDro) through 20 March 2015. Methodological quality was assessed using the Quality Appraisal of Reliability Studies (QAREL) tool by 2 independent reviewers.
  
  
  RESULTS
  The search strategy revealed 3259 articles, of which 18 finally met the inclusion criteria. These studies evaluated the reliability of 62 test and test variations used for the specific physical examination tests for the diagnosis of shoulder pathologies. Methodological quality ranged from 2 to 7 positive criteria of the 11 items of the QAREL tool.
  
  
  CONCLUSIONS
  This review identified a lack of high-quality studies evaluating inter-rater as well as intrarater reliability of specific physical examination tests for the diagnosis of shoulder pathologies. In addition, reliability measures differed between included studies hindering proper cross-study comparisons.
  
  
  BACKGROUND
  PROSPERO CRD42014009018.
authors.affiliation: Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus Dresden, Dresden, Germany.
authors.forename: Toni
authors.initials: T
authors.lastname: Lange
authors.affiliation: Texas Tech University, School of Health Professions, Lubbock, Texas, USA.|International Academy of Orthopedic Medicine-Europe, Stuttgart, Germany.
authors.forename: Omer
authors.initials: O
authors.lastname: Matthijs
authors.affiliation: Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: Nitin B
authors.initials: NB
authors.lastname: Jain
authors.affiliation: Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus Dresden, Dresden, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Schmitt
authors.affiliation: Department of Orthopaedic and Trauma Surgery, University Hospital Carl Gustav Carus Dresden, Dresden, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Lützner
authors.affiliation: Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus Dresden, Dresden, Germany.|Department für Angewandte Gesundheitswissenschaften, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Kopkow
mesh_terms: D006801:Humans; D015588:Observer Variation; D010808:Physical Examination / Q000379:methods* / Q000592:standards; D015203:Reproducibility of Results; D020069:Shoulder Pain / Q000175:diagnosis* / Q000209:etiology
keywords: Reliability; Review; Shoulder