Hoving J L, Buchbinder R, Green S, Forbes A, Bellamy N, Brand C, Buchanan R, Hall S, Patrick M, Ryan P, Stockman A
Department of Clinical Epidemiology, Cabrini Hospital, Australia.
Ann Rheum Dis. 2002 Jul;61(7):612-6. doi: 10.1136/ard.61.7.612.
To assess the intrarater and interrater reliability among rheumatologists of a standardised protocol for measurement of shoulder movements using a gravity inclinometer.
After instruction, six rheumatologists independently assessed eight movements of the shoulder, including total and glenohumeral flexion, total and glenohumeral abduction, external rotation in neutral and in abduction, internal rotation in abduction and hand behind back, in random order in six patients with shoulder pain and stiffness according to a 6x6 Latin square design using a standardised protocol. These assessments were then repeated. Analysis of variance was used to partition total variability into components of variance in order to calculate intraclass correlation coefficients (ICCs).
The intrarater and interrater reliability of different shoulder movements varied widely. The movement of hand behind back and total shoulder flexion yielded the highest ICC scores for both intrarater reliability (0.91 and 0.83, respectively) and interrater reliability (0.80 and 0.72, respectively). Low ICC scores were found for the movements of glenohumeral abduction, external rotation in abduction, and internal rotation in abduction (intrarater ICCs 0.35, 0.43, and 0.32, respectively), and external rotation in neutral, external rotation in abduction, and internal rotation in abduction (interrater ICCs 0.29, 0.11, and 0.06, respectively).
The measurement of shoulder movements using a standardised protocol by rheumatologists produced variable intrarater and interrater reliability. Reasonable reliability was obtained only for the movement of hand behind back and total shoulder flexion.
评估风湿病学家使用重力倾角仪测量肩部运动的标准化方案的评估者内和评估者间信度。
在接受指导后，六名风湿病学家根据6×6拉丁方设计，按照标准化方案，对六名肩部疼痛和僵硬患者的八个肩部运动进行独立评估，这些运动包括全肩关节和肱盂关节的前屈、全肩关节和肱盂关节的外展、中立位和外展位的外旋、外展位的内旋以及手背后，评估顺序随机。然后重复这些评估。采用方差分析将总变异分解为方差成分，以计算组内相关系数（ICC）。
不同肩部运动的评估者内和评估者间信度差异很大。手背后和全肩关节前屈运动在评估者内信度（分别为0.91和0.83）和评估者间信度（分别为0.80和0.72）方面均获得最高的ICC分数。肱盂关节外展、外展位外旋和外展位内旋运动的ICC分数较低（评估者内ICC分别为0.35、0.43和0.32），中立位外旋、外展位外旋和外展位内旋运动的评估者间ICC分数也较低（分别为0.29、0.11和0.06）。
风湿病学家使用标准化方案测量肩部运动产生了不同的评估者内和评估者间信度。仅在手背后和全肩关节前屈运动中获得了合理的信度。
