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 kappa 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.