Intertester reliability of a classification system for shoulder pain.

Area of Science:

• Orthopedics
• Physical Therapy
• Clinical Diagnostics

Background:

• Shoulder pain is a common musculoskeletal complaint.
• Accurate classification of shoulder syndromes is crucial for effective treatment.
• Existing classification systems may lack sufficient intertester reliability.

Purpose of the Study:

• To introduce and evaluate the intertester reliability of a novel shoulder syndrome classification system.
• To determine the reproducibility of this classification system in a primary care physiotherapy setting.

Main Methods:

• An intertester reliability study design was employed.
• Fifty-five physiotherapists assessed 255 patients with shoulder pain across 14 clinics.
• Patients were classified into three distinct shoulder pain patterns: impingement, acromioclavicular joint pain, and other shoulder pain syndromes.

Main Results:

• Physiotherapists achieved an 80% agreement rate in classifying shoulder pain patterns.
• The Cohen's kappa coefficient was 0.664, indicating good reproducibility (P<0.001).
• Pattern 1 (impingement pain) was the most frequently agreed-upon diagnosis (68% of agreements).

Conclusions:

• The developed shoulder pain classification system demonstrates good intertester reliability.
• The system effectively utilizes key clinical history and examination findings.
• This classification approach offers a reproducible method for diagnosing shoulder pain syndromes.