Reliability of specific physical examination tests for the diagnosis of shoulder pathologies: a systematic review and meta-analysis

Lange, Toni; Matthijs, Omer; Jain, Nitin B.; Schmitt, Jochen; Lützner, Jörg; Kopkow, Christian

doi:10.1136/bjsports-2016-096558

Cited by 23 publications

(22 citation statements)

References 78 publications

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“…We chose the diagnosis M75 because its subgroups are partially overlapping and often not distinguishable in a clinical assessment. The lack of universally accepted diagnostic classification criteria,34 poor specificity of many physical examination tests35 and inconsistent diagnostic terminology36 may make the clinical diagnosis more or less inaccurate. In this study, we decided to rule out traumas because they were unsystematically recorded in the used registers.…”

Section: Discussionmentioning

confidence: 99%

Work participation and working life expectancy after a disabling shoulder lesion

et al. 2019

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ObjectiveTo examine the impact of a disabling non-traumatic shoulder lesion on work participation and working life expectancy.MethodsFrom a 70% random sample of the Finnish population, we selected 30–59-year-old wage earners with prolonged sickness absence due to a shoulder lesion (n=7644). We followed the persons from 2006 to 2014 and calculated the proportion of time a person spent in different work participation statuses. The associations of potential determinants with a preterm exit from paid employment were tested using Cox regression. Years expected to be spent in different work participation statuses were estimated applying the Sullivan method for healthy life expectancy.ResultsDuring 9 years of follow-up time spent at work was reduced from 77.7% to 46.7%, and 15.8% of the persons were granted disability retirement, mostly due to shoulder and other musculoskeletal diseases. Compared with the general population persons with a disabling shoulder disease are expected to lose from 1.8 to 8.1 years of working life, depending on their age. Age, gender, education, duration of initial sickness absence due to the shoulder lesion, not being able to return to work sustainably and participation in vocational rehabilitation predicted preterm exit from work. Heavy lifting increased the risk of preterm exit marginally.ConclusionsWorking life expectancy is markedly reduced in persons with a disabling shoulder lesion, mainly because of disability retirement due to musculoskeletal problems. Clinicians should consider interventions targeted at improving musculoskeletal functioning and necessary work modifications before shoulder problems become chronic or the persons develop disabling comorbid musculoskeletal conditions.

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Section: Discussionmentioning

confidence: 99%

Work participation and working life expectancy after a disabling shoulder lesion

et al. 2019

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“…Reporting the ICC and/or CCC along with associated 95% confidence intervals is good practice for agreement analysis. The results are reported in both primary (such as reliability analysis of the Microbleed Anatomical Rating Scale in the evaluation of microbleeds [143], automatic analysis of relaxation parameters of the upper esophageal sphincter [144], and the use of signal intensity weighted centroid in magnetic resonance images of patients with discs degeneration [145]) and secondary research studies (systematic review and/or meta-analysis: evaluation of the functional movement screen [146], evaluation of the Manchester triage scale on an emergency department [147], reliability of the specific physical examination tests for the diagnosis of shoulder pathologies [148], etc. ).…”

Section: Diagnostic Tests and Statistical Methodsmentioning

confidence: 99%

Medical Diagnostic Tests: A Review of Test Anatomy, Phases, and Statistical Treatment of Data

Bolboacă

2019

Computational and Mathematical Methods in Medicine

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Diagnostic tests are approaches used in clinical practice to identify with high accuracy the disease of a particular patient and thus to provide early and proper treatment. Reporting high-quality results of diagnostic tests, for both basic and advanced methods, is solely the responsibility of the authors. Despite the existence of recommendation and standards regarding the content or format of statistical aspects, the quality of what and how the statistic is reported when a diagnostic test is assessed varied from excellent to very poor. This article briefly reviews the steps in the evaluation of a diagnostic test from the anatomy, to the role in clinical practice, and to the statistical methods used to show their performances. The statistical approaches are linked with the phase, clinical question, and objective and are accompanied by examples. More details are provided for phase I and II studies while the statistical treatment of phase III and IV is just briefly presented. Several free online resources useful in the calculation of some statistics are also given.

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“…The primary aim of this investigation was to (1) determine the prevalence of patients with shoulder impairments classified into the MDT syndromes (i.e. Shoulder Derangement, Shoulder Dysfunction, Posture, and Other) and (2) analyze the interaction between classification and outcomes. Descriptive statistics were calculated for patient characteristics including MDT classifications, patients with intake data only, and patients with intake and discharge data.…”

Section: Methodsmentioning

confidence: 99%

“…Establishing a tissue-specific shoulder diagnosis is difficult at best. Numerous reports have shown unacceptable levels of reliability [1,2] and validity [3][4][5][6] for the clinical tests used to establish a pathoanatomical shoulder diagnosis. Furthermore, radiological studies of the shoulder are subject to a high prevalence of incidental findings, and structural abnormalities including rotator cuff pathology [7][8][9][10] and labral tears [11,12] commonly occur in asymptomatic individuals.…”

Section: Introductionmentioning

confidence: 99%

A prospective study of patients with shoulder pain and Mechanical Diagnosis and Therapy (MDT)

Yarznbowicz

2019

Journal of Manual & Manipulative Therapy

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Objectives: A prospective observational cohort study was conducted to (1) determine the prevalence of Mechanical Diagnosis and Therapy (MDT) syndromes for patients with shoulder impairments and (2) report the interaction between MDT classification and clinical outcomes, including pain intensity and disability, at discharge. Methods: Clinical outcome measures were completed at intake and discharge by 115 patients. A two-way mixed model analysis of variance with subsequent pairwise comparisons was done to examine differences in clinical outcomes between the following MDT classifications: Shoulder Derangement, Shoulder Dysfunction, and Other. Results: The primary findings were that (1) 44.3 (35.3, 53.4), 40.0 (31.0, 48.9), and 15.6 (9.0, 22.3) percent of patients' conditions were classified as Shoulder Derangement, Shoulder Dysfunction, and Other, respectively, (2) all groups managed via MDT methods made clinically significant improvements in disability and pain intensity at discharge, (3) a statistically significant difference in pain intensity at discharge was observed between the Shoulder Derangement and the Shoulder Dysfunction classifications (p = 0.01), and (4) patients with the Shoulder Derangement classification were discharged, on average, 35.3 days earlier than the Shoulder Dysfunction classification and 28.3 days earlier than the Other classification. Discussion: This study confirms previous reports that the Shoulder Derangement and Shoulder Dysfunction classifications are common and represent distinct clinical trajectories when assessed and managed via MDT methods.

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Reliability of specific physical examination tests for the diagnosis of shoulder pathologies: a systematic review and meta-analysis

Abstract: PROSPERO CRD42014009018.

Cited by 23 publications

References 78 publications

Work participation and working life expectancy after a disabling shoulder lesion

Work participation and working life expectancy after a disabling shoulder lesion

Medical Diagnostic Tests: A Review of Test Anatomy, Phases, and Statistical Treatment of Data

A prospective study of patients with shoulder pain and Mechanical Diagnosis and Therapy (MDT)

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