Hemiplegic shoulder pain syndrome: Interrater reliability of physical diagnosis signs

Objective: To determine the interrater reliability of shoulder physical diagnosis signs in the acute stroke rehabilitation setting. Design: Prospective inception cohort. Setting: Academic inpatient stroke rehabilitation service. Participants: People admitted to stroke rehabilitation service. Interventions: Not applicable. Main Outcome Measures: The Neer impingement test, Speed test, acromioclavicular shear test, Rowe shoulder score, and palpation. Results: Two examiners evaluated 46 consecutively admitted participants at 18.9±14.1 days after stroke. Percentage agreement was 78% or higher on all tests. The κ statistic was in the fair to excellent interrater reliability range on all tests except those involving the acromioclavicular joint, for which findings were infrequent. Conclusions: Most of the shoulder physical diagnosis signs used in this study have sufficient interrater reliability for use in future clinical studies of hemiplegic shoulder pain.