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Research
Inter-rater reliability of the Shoulder Symptom Modification Procedure in people with shoulder pain
  1. Jeremy S Lewis1,2,
  2. Karen McCreesh2,
  3. Eva Barratt2,
  4. Eric J Hegedus3,
  5. Julius Sim4
  1. 1School of Health and Social Work, University of Hertfordshire, Hatfield, UK
  2. 2Department of Clinical Therapies, University of Limerick, Limerick, Ireland
  3. 3Department of Physical Therapy, Congdon School of Health Sciences, High Point University, High Point, North Carolina, USA
  4. 4Institute for Primary Care and Health Sciences, Keele University, Stoke-on-Trent, UK
  1. Correspondence to Dr Jeremy S Lewis; jeremy.lewis{at}londonshoulderclinic.com

Abstract

Background Musculoskeletal conditions involving the shoulder are common and, because of the importance of the upper limb and hand in daily function, symptoms in this region are commonly associated with functional impairment in athletic and non-athletic populations. Deriving a definitive diagnosis as to the cause of shoulder symptoms is fraught with difficulty. Limitations have been recognised for imaging and for orthopaedic special tests. 1 solution is to partially base management on the response to tests aimed at reducing the severity of the patient's perception of symptoms. 1 (of many) such tests is the Shoulder Symptom Modification Procedure (SSMP). The reliability of this procedure is unknown.

Methods 37 clinician participants independently watched the videos of 11 patient participants undergoing the SSMP and recorded each patient's response as improved (partially or completely), no change or worse. Inter-rater reliability was assessed by Krippendorff's α, which ranges from 0 to 1.

Results Krippendorff's α was found to range from 0.762 to 1.000, indicating moderate to substantial reliability. In addition, short (3-hour) and longer (1-day) durations of training were associated with similar levels of reliability across the techniques.

Conclusions Deriving a definitive structural diagnosis for a person presenting with a musculoskeletal condition involving the shoulder is difficult. The findings of the present study suggest that the SSMP demonstrates a high level of reliability. More research is needed to better understand the relevance of such procedures.

Trial registration number ISRCTN95412360.

  • Shoulder
  • Assessing validity and reliability of test of physiological parameters
  • Physiotherapy

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjsem-2016-000181

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    Footnotes

    • Twitter Follow Jeremy Lewis at @JeremyLewisPT

    • Contributors JSL, KM, EB and EJH designed the study protocol. JSL, KM and EB collected the data. JS performed the statistical analysis. All authors read and approved the final manuscript.

    • Competing interests JSL conceived the idea behind the SSMP and has presented the concept internationally.

    • Patient consent Obtained.

    • Ethics approval Research Ethics Committee, University of Limerick, Ireland (2015_12_13_EHS), and from the Health and Human Sciences Ethics Committee, University of Hertfordshire, UK.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.