Intra-rater and inter-rater reliability of the standardized ultrasound protocol for assessing subacromial structures

Kjær, Birgitte Hougs; Ellegaard, Karen; Wieland, Inge; Warming, Susan; Juul-Kristensen, Birgit

doi:10.1080/09593985.2017.1318419

Cited by 25 publications

(47 citation statements)

References 49 publications

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“…Some studies have found significant differences in TT between symptomatic and non-symptomatic participants, 29 30 which are in contrast with the current study and a recent study. 18 The reason for the discrepancy across studies may be due to the use of different methods for measuring TT, small sample sizes, different inclusion criteria or, as in this study, the inclusion of more active controls (recruited among health personnel) with potentially thicker tendons than the average population.…”

Section: Discussionmentioning

confidence: 86%

“…Excellent reliability, and MDC of ≤0.33 mm, indicates that the variable is sensitive for detecting changes, in line with a previous study using the same method for measuring TT. 18 This means that it may be a clinically relevant measurement for assessment of changes in tendon properties, such as increased/decreased oedema. Some studies have found significant differences in TT between symptomatic and non-symptomatic participants, 29 30 which are in contrast with the current study and a recent study.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound assessment for grading structural tendon changes in supraspinatus tendinopathy: an inter-rater reliability study

et al. 2016

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AimTo evaluate the inter-rater reliability of measuring structural changes in the tendon of patients, clinically diagnosed with supraspinatus tendinopathy (cases) and healthy participants (controls), on ultrasound (US) images captured by standardised procedures.MethodsA total of 40 participants (24 patients) were included for assessing inter-rater reliability of measurements of fibrillar disruption, neovascularity, as well as the number and total length of calcifications and tendon thickness. Linear weighted κ, intraclass correlation (ICC), SEM, limits of agreement (LOA) and minimal detectable change (MDC) were used to evaluate reliability.Results‘Moderate—almost perfect’ κ was found for grading fibrillar disruption, neovascularity and number of calcifications (k 0.60–0.96). For total length of calcifications and tendon thickness, ICC was ‘excellent’ (0.85–0.90), with SEM(Agreement) ranging from 0.63 to 2.94 mm and MDC(group) ranging from 0.28 to 1.29 mm. In general, SEM, LOA and MDC showed larger variation for calcifications than for tendon thickness.ConclusionsInter-rater reliability was moderate to almost perfect when a standardised procedure was applied for measuring structural changes on captured US images and movie sequences of relevance for patients with supraspinatus tendinopathy. Future studies should test intra-rater and inter-rater reliability of the method in vivo for use in clinical practice, in addition to validation against a gold standard, such as MRI.Trial registration numberNCT01984203; Pre-results.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Ultrasound assessment for grading structural tendon changes in supraspinatus tendinopathy: an inter-rater reliability study

et al. 2016

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“…This may be directly proportional to SMT exposure. Different authors used this positioning technique for the SMT examination [36,37].…”

Section: Discussionmentioning

confidence: 99%

Inter-and Intra-Examiner Reliability of Supraspinatus Muscle Tendon Palpation: A Cross-Sectional Study by Ultrasonography

et al. 2020

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Background and objectives: Palpation is an inherent and basic skill of health professionals—particularly manual therapists who base their diagnosis and treatment in a clinical environment. Many authors have previously described multiple palpation positions for supraspinatus muscle tendon (SMT); however, there are no current studies that evaluate palpation concordance reliability for the SMT in this particular position. This study aimed to investigate the intra- and inter-rater reliabilities of supraspinatus muscle tendon (SMT) palpation. Materials and Methods: Thirty-six healthy participants (14 females; aged 22–35 years) were recruited. Musculoskeletal ultrasound was used to measure the SMT localization after two physiotherapists performed the SMT palpation at two different times. The distance between the two marked points was used to analyze the analysis of true agreement between examiners. Finally, we analyzed if the demographic variables influenced the palpation procedure. Results: The intra-examiner reliability showed a high percentage of concordance for examiner 1 (E.1) (first palpation procedure (P.1) = 91.7%: second palpation procedure (P.2) = 95.8%) and examiner 2 (E.2) (P.1 = 91.6%; P.2 = 97.2%) and high percentage of inter-palpation agreement for E.1 (87.5%) and E.2 (88.9%). The inter-examiner reliability showed a high total concordance for the right shoulder (E.1 = 94.4%; E.2 = 95.8%) and left shoulder (E.1 = 93.05%; E.2 = 95.05%). The agreement (%) according to both examiners was 93.05% for the right shoulder and 94.4% for the left shoulder. The agreement between both examiners and the ultrasound (% of true agreement) was 92.9% for the right shoulder and 92.8% for the left shoulder. A statistically significant association (p = 0.02) was found for weight regarding concordance reliability; this was not seen for dominant arm, age, gender, body mass index, height, and tendon depth (p > 0.05). Conclusions: The SMT palpation technique showed a high level of concordance and reproducibility.

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“…Ultrasound images are captured with the patients seated in an upright position, feet flat on the floor, neutral trunk posture, and head facing forward. For the SST thickness measure the patient has the hand on the affected side on the ipsilateral posterior hip with the humerus in extension and the tendon is measured in a longitudinal [72] and a transverse view [67]. AHD is measured in the neutral position (arm resting at the side) and respectively with 45° and 60° of active shoulder elevation in the scapular plane [72, 73].…”

Section: Methodsmentioning

confidence: 99%

“…For the SST thickness measure the patient has the hand on the affected side on the ipsilateral posterior hip with the humerus in extension and the tendon is measured in a longitudinal [72] and a transverse view [67]. AHD is measured in the neutral position (arm resting at the side) and respectively with 45° and 60° of active shoulder elevation in the scapular plane [72, 73]. SST neovascularity assessed by power Doppler is measured with the shoulder internally rotated with the dorsal side of the hand placed on the sacrum, and the elbow flexed and directed laterally [74].…”

Section: Methodsmentioning

confidence: 99%

Progressive early passive and active exercise therapy after surgical rotator cuff repair – study protocol for a randomized controlled trial (the CUT-N-MOVE trial)

Kjær

Magnusson

Warming

et al. 2018

Trials

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BackgroundRotator cuff tear is a common cause of shoulder disability and results in patients predominantly complaining of pain and loss of motion and strength. Traumatic rotator cuff tears are typically managed surgically followed by ~ 20 weeks of rehabilitation. However, the timing and intensity of the postoperative rehabilitation strategy required to reach an optimal clinical outcome is unknown. Early controlled and gradually increased tendon loading has been suggested to positively influence tendon healing and recovery. The aim of this trial is therefore to examine the effect of a progressive rehabilitation strategy on pain, physical function and quality of life compared to usual care (that limits tendon loading in the early postoperative phase) in patients who have a rotator cuff repair of a traumatic tear.MethodsThe current study is a randomized, controlled, outcome-assessor blinded, multicenter, superiority trial with a two-group paralleled design. A total of 100 patients with surgically repaired traumatic rotator cuff tears will be recruited from up to three orthopedic departments in Denmark, and randomized to either a progressive early passive and active movement program or a limited early passive movement program (usual care). The primary outcome measure will be the change from pre-surgery to 12 weeks post-surgery in the Western Ontario Rotator Cuff Index questionnaire. Secondary outcomes include the Disabilities Arm, Shoulder and Hand questionnaire (DASH), range of motion, strength and tendon healing characteristics from ultrasound measurements at 12 months follow up.DiscussionWe hypothesized that patients who receive the progressive rehabilitation strategy will benefit more with respect to pain reduction, physical function and quality of life than those who receive care as usual. If this is confirmed our study can be used clinically to enhance the recovery of patients with traumatic rotator cuff tear.Trial registrationClinicalTrials.gov, NCT02969135. Registered on 15 November 2016.Electronic supplementary materialThe online version of this article (10.1186/s13063-018-2839-5) contains supplementary material, which is available to authorized users.

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Intra-rater and inter-rater reliability of the standardized ultrasound protocol for assessing subacromial structures

Abstract: The reliability of the current standardized protocol for US examination of SI was excellent and considered feasible for clinical practice.

Cited by 25 publications

References 49 publications

Ultrasound assessment for grading structural tendon changes in supraspinatus tendinopathy: an inter-rater reliability study

Ultrasound assessment for grading structural tendon changes in supraspinatus tendinopathy: an inter-rater reliability study

Inter-and Intra-Examiner Reliability of Supraspinatus Muscle Tendon Palpation: A Cross-Sectional Study by Ultrasonography

Progressive early passive and active exercise therapy after surgical rotator cuff repair – study protocol for a randomized controlled trial (the CUT-N-MOVE trial)

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