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Reliability and Concurrent Validity of Shoulder Tissue Irritability Classification.

Stephen M Kareha1, Philip W McClure2, Alicia Fernandez-Fernandez3

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|January 22, 2021
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Summary
This summary is machine-generated.

The STAR-Shoulder tissue irritability rating system shows acceptable reliability and a strong link with patient outcomes, supporting its use in clinical decision-making for shoulder pain.

Keywords:
DiagnosisDifferential DiagnosisDosageIntensityPatient-Reported Outcome MeasuresTreatment Strategy

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Area of Science:

  • Orthopedics
  • Physical Therapy
  • Clinical Measurement

Background:

  • Clinical practice guidelines recommend rating tissue irritability for decision-making.
  • The Staged Algorithm for Rehabilitation Classification: Shoulder Disorders (STAR-Shoulder) proposed a method for rating tissue irritability.
  • The reliability and validity of the STAR-Shoulder irritability rating system were previously unknown.

Purpose of the Study:

  • To examine the reliability of shoulder tissue irritability ratings.
  • To assess the concurrent validity of shoulder tissue irritability ratings.
  • To determine the utility of the STAR-Shoulder system in guiding treatment strategy and intensity.

Main Methods:

  • A prospective, repeated-measures, cross-sectional design was employed.
  • 101 participants with shoulder pain were assessed by blinded raters for tissue irritability.
  • Patient-reported outcome (PRO) measures of pain and disability were collected and compared with irritability ratings.

Main Results:

  • Interrater reliability for tissue irritability was 0.69 (67% agreement).
  • All PRO measures showed significant differences across the three levels of tissue irritability.
  • Receiver operating characteristic curve analysis was used to derive cut-off scores for PRO instruments.

Conclusions:

  • The STAR-Shoulder tissue irritability rating system demonstrates acceptable reliability.
  • A strong relationship exists between PRO measures and therapist-rated tissue irritability.
  • These findings support the clinical use of the STAR-Shoulder irritability rating system for guiding treatment.