Movement Diagram and “End-Feel” Reliability When Measuring Passive Lateral Rotation of the Shoulder in Patients With Shoulder Pathology

BACKGROUND AND PURPOSE: Findings related to joint function can be recorded with movement diagrams or by characterizing the "end-feel" according to the procedure described by Cyriax. Because both methods are used to classify pain and resistance in relation to joint range of motion (ROM), the purpose of this study was to simultaneously evaluate the reliability of these categorizations in a patient sample. SUBJECTS: Two physical therapists performed 2 assessments of passive lateral rotation of the shoulder in 34 patients. METHODS: Pain and resistance findings were recorded using movement diagrams and end-feel categories. Intraclass correlation coefficients (ICC[2,1]) were used to analyze the ratio (movement diagram) data, and kappa statistics (kappa) were used to analyze the categorical (end-feel) data. RESULTS: Intrarater ICCs varied from .58 to .89. Interrater ICCs for locating maximum pain and resistance in joint ROM varied from .85 to .91. Other interrater ICCs were lower (ICC = .34-.88). Intrarater kappa values for end-feel were moderate (kappa = .48-.59), and interrater kappa values were substantial (kappa = .62-.76). CONCLUSION AND DISCUSSION: Movement diagram measures conceptually related to the end of joint ROM and end-feel were highly reliable. This finding and the fact that additional end-feel categories were introduced in the study may partially explain the end-feel reliability findings. Consideration of their use in future studies may help to determine their clinical utility.