Passive Range of Movement of the Shoulder: A Standardized Method for Measurement and Assessment of Intrarater Reliability

Abstract

OBJECTIVE: The purpose of this study was to determine the intrarater reliability and reproducibility of a standardized procedure for measuring passive shoulder movement in asymptomatic individuals. METHODS: A single assessor used a digital inclinometer and standardized protocol to measure the passive range of motion of 7 shoulder movements in 168 asymptomatic shoulders. Following a warm-up maneuver, 3 measurements were taken for each movement on 2 occasions. Both shoulders were measured using a standardized order of movement. Selection of measurement beginning with left or right shoulder was randomly determined. The entire process was repeated 7 days later to assess reproducibility. Intraclass correlation coefficients (ICCs) with 95% confidence intervals and standard errors of measurement (SEMs) were calculated to assess the intrarater reliability of the methods. RESULTS: The intrarater reliability of our methods was substantial for total shoulder flexion (ICC = 0.82, SEM = 12.3°), whereas all other movements demonstrated moderate reliability (ICC range = 0.64-0.75) except external rotation in neutral abduction, for which reliability was classed as slight (ICC = 0.28, SEM = 31°). Moderate reliability was evident for all movements on follow-up at 7 days (ICC range = 0.60-0.77). CONCLUSIONS: These methods of measurement have moderate to substantial reliability for the majority of tested passive shoulder movements, with moderate reliability sustained after 1 week, in a large sample of asymptomatic individuals.