Reproducibility of range of motion and muscle strength measurements in patients with hip osteoarthritis – an inter-rater studyReport as inadecuate




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BMC Musculoskeletal Disorders

, 13:242

First Online: 06 December 2012Received: 14 March 2012Accepted: 30 November 2012

Abstract

BackgroundAssessment of range of motion ROM and muscle strength is fundamental in the clinical diagnosis of hip osteoarthritis OA but reproducibility of these measurements has mostly involved clinicians from secondary care and has rarely reported agreement parameters. Therefore, the primary objective of the study was to determine the inter-rater reproducibility of ROM and muscle strength measurements. Furthermore, the reliability of the overall assessment of clinical hip OA was evaluated. Reporting is in accordance with proposed guidelines for the reporting of reliability and agreement studies GRRAS.

MethodsIn a university hospital, four blinded raters independently examined patients with unilateral hip OA; two hospital orthopaedists independently examined 48 24 men patients and two primary care chiropractors examined 61 patients 29 men. ROM was measured in degrees deg. with a standard two-arm goniometer and muscle strength in Newton N using a hand-held dynamometer. Reproducibility is reported as agreement and reliability between paired raters of the same profession. Agreement is reported as limits of agreement LoA and reliability is reported with intraclass correlation coefficients ICC. Reliability of the overall assessment of clinical OA is reported as weighted kappa.

ResultsBetween orthopaedists, agreement for ROM ranged from LoA -28–12 deg. for internal rotation to -8–13 deg. for extension. ICC ranged between 0.53 and 0.73, highest for flexion. For muscle strength between orthopaedists, LoA ranged from -65–47N for external rotation to -10 –59N for flexion. ICC ranged between 0.52 and 0.85, highest for abduction. Between chiropractors, agreement for ROM ranged from LoA -25–30 deg. for internal rotation to -13–21 deg. for flexion. ICC ranged between 0.14 and 0.79, highest for flexion. For muscle strength between chiropractors, LoA ranged between -80–20N for external rotation to -146–55N for abduction. ICC ranged between 0.38 and 0.81, highest for flexion. Weighted kappa for the overall assessment of clinical hip OA was 0.52 between orthopaedists and 0.65 between chiropractors.

ConclusionsReproducibility of goniometric and dynamometric measurements of ROM and muscle strength in patients with hip OA is poor between experienced orthopaedists and between experienced chiropractors. Orthopaedists and chiropractors can to a moderate degree differentiate between hips with or without osteoarthritis.

KeywordsHip Examination Inter-observer Reliability Osteoarthritis Hip AbbreviationsOAOsteoarthritis

ROMRange of motion

DegDegrees

HHDHand-held dynamometer

NNewton

ICCIntraclass correlation coefficient

SDStandard deviation

CIConfidence interval

LoALimits of agreement.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2474-13-242 contains supplementary material, which is available to authorized users.

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Author: Erik Poulsen - Henrik Wulff Christensen - Jeannette Østergaard Penny - Søren Overgaard - Werner Vach - Jan Hartvigsen

Source: https://link.springer.com/







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