Measuring subluxation of the hemiplegic shoulder: reliability of a method

Neurorehabil Neural Repair. 2001;15(3):249-54. doi: 10.1177/154596830101500314.

Abstract

Objective: Subluxation of the shoulder after stroke can be measured according to the method described by Van Langenberghe and Hogan.

Methods: To evaluate the reliability of this method, the shoulder radiographs of 25 patients were available for this study. Two independent raters each assessed these radiographs twice.

Results: The intrarater reliability was good: percentage of agreement was 88 and 84%, weighted kappa, 0.69 [95% confidence interval (CI), 0.38-1.0] and 0.78 (95% CI, 0.60-0.95) for raters 1 and 2, respectively. The interrater reliability was poor: percentage of agreement was 36 and 28%, kappa, 0.11 (95% CI, 0.0-0.31) and 0.09 (95% CI, 0.0-0.23) in sessions 1 and 2, respectively. Subsequently the original method was adjusted by combining two categories (no subluxation and beginning subluxation) into one ("no clinically important subluxation").

Conclusions: After this adjustment of the categories, the interrater reliability improved [percentage of agreement, 72%, and kappa, 0.49 (95% CI, 0.18-0.80)], but did not reach acceptable values.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthrography / methods
  • Arthrography / standards*
  • Arthrography / statistics & numerical data
  • Female
  • Hemiplegia / complications
  • Hemiplegia / diagnostic imaging*
  • Humans
  • Male
  • Middle Aged
  • Observer Variation
  • Pain / diagnostic imaging
  • Reproducibility of Results
  • Shoulder Dislocation / diagnostic imaging*
  • Shoulder Dislocation / etiology
  • Shoulder Joint / diagnostic imaging
  • Stroke / complications
  • Stroke / diagnostic imaging*