Snels I A, Beckerman H, ten Kate J J, Lankhorst G J, Bouter L M
Department of Rehabilitation Medicine, University Hospital, and Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands.
Neurorehabil Neural Repair. 2001;15(3):249-54. doi: 10.1177/154596830101500314.
Subluxation of the shoulder after stroke can be measured according to the method described by Van Langenberghe and Hogan.
To evaluate the reliability of this method, the shoulder radiographs of 25 patients were available for this study. Two independent raters each assessed these radiographs twice.
The intrarater reliability was good: percentage of agreement was 88 and 84%, weighted kappa, 0.69 [95% confidence interval (CI), 0.38-1.0] and 0.78 (95% CI, 0.60-0.95) for raters 1 and 2, respectively. The interrater reliability was poor: percentage of agreement was 36 and 28%, kappa, 0.11 (95% CI, 0.0-0.31) and 0.09 (95% CI, 0.0-0.23) in sessions 1 and 2, respectively. Subsequently the original method was adjusted by combining two categories (no subluxation and beginning subluxation) into one ("no clinically important subluxation").
After this adjustment of the categories, the interrater reliability improved [percentage of agreement, 72%, and kappa, 0.49 (95% CI, 0.18-0.80)], but did not reach acceptable values.
中风后肩部半脱位可根据范·朗根贝赫和霍根描述的方法进行测量。
为评估该方法的可靠性，本研究获取了25例患者的肩部X线片。两名独立评估者各自对这些X线片进行了两次评估。
评估者内信度良好：评估者1和评估者2的一致性百分比分别为88%和84%，加权kappa值分别为0.69[95%置信区间（CI），0.38 - 1.0]和0.78（95%CI，0.60 - 0.95）。评估者间信度较差：在第1次和第2次评估中，一致性百分比分别为36%和28%，kappa值分别为0.11（95%CI，0.0 - 0.31）和0.09（95%CI，0.0 - 0.23）。随后，通过将两个类别（无半脱位和开始出现半脱位）合并为一个（“无临床重要半脱位”）对原始方法进行了调整。
经过这种类别调整后，评估者间信度有所提高[一致性百分比为72%，kappa值为0.49（95%CI，0.18 - 0.80）]，但未达到可接受值。
