Inter-rater reliability of ultrasound measurements of acromion-greater tuberosity distance between experienced and novice raters in healthy people.

Praveen Kumar,Matthew Attwood

doi:10.1002/msc.1206

Abstract

Acromion-greater tuberosity (AGT) distance is used to assess shoulder pathologies including rotator cuff tears. The aim of this pilot study was, to provide short course of training and assess inter-rater reliability of ultrasonographic measurements of AGT distance between experienced and novice raters (physiotherapy students) in healthy individuals prior to testing on patient populations. Eleven healthy individuals with a mean age 54 years (SD 5) who gave informed written consent were recruited. Three ﬁnal year physiotherapy students acted as novice raters and an experience rater (physiotherapist) recorded the ultrasound measurements of AGT distance on both shoulders using a standardised protocol. ICC values for inter-rater reliability between experienced rater and novice raters 1, 2 and 3 for the left shoulder were 0.83 (95% CI 0.63-0.94), 0.87 (95% CI 0.73-0.96) and 0.61 (95% CI 0.37-0.85) respectively. Corresponding values for the right shoulder were 0.85 (95% CI 0.70- 0.95), 0.75 (95% CI 0.55-0.91) and 0.62 (95% CI 0.38-0.85). The standard error of measurement (SEM) and minimum detectable change (MDC) were ≤0.2cm and ≤0.3 cm respectively for all the raters. Evidence from this study provides further support for the potential usefulness of ultrasound in both research and clinical practice for the management of shoulder pathologies.

Highlights

Reduction in the acromion-humeral distance (AHD) is used as a predictive marker in identifying rotator cuff tears (Cholewinski et al, 2008)
A summary of descriptive data for acromion-greater tuberosity (AGT) distance measurements for all four raters is provided in table 1
ICC, standard error of measurement, and MDC90 for interrater reliability for both right and left shoulders are presented in table 2

Summary

Introduction

Reduction in the acromion-humeral distance (AHD) is used as a predictive marker in identifying rotator cuff tears (Cholewinski et al, 2008). Several studies have reported reliability of ultrasonographic measurements of AHD in both healthy participants (Desmeules et al, 2004) and in patients with rotator cuff injuries and supraspinatus impingement syndrome (SIS) (Azzoni et al, 2004; Desmeules et al, 2004; Kalra et al, 2010; Pijls et al 2010). Kalra et al (2010) reported excellent test-retest reliability (ICC 0.76-0.92) of AHD measurements in patients with rotator cuff tears. That study reported good interrater reliability (ICC 0.70) between experienced and novice raters for AHD measurements in the neutral shoulder position

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Conclusion