Intratester and intertester reliability of the movement system impairment-based classification for patients with knee pain

Kajbafvala, Mehrnaz; Ebrahimi, Ismaeil; Salavati, Mahyar; Saeedi, Ahmad; Pourahmadi, Mohammadreza; Ashnagar, Zinat; Yazdi, Mohammad Jafar Shaterzadeh; Amiri, Ali

doi:10.1016/j.math.2016.07.014

Cited by 9 publications

(10 citation statements)

References 28 publications

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“…The reliability and validity of the system for some anatomical regions have been partially described. 8 , 52 , 56 , 57 , 58 , 59 , 60 , 62 , 71 , 72 , 73 , 75 , 76 , 77 , 78 Several case reports describing MSI examination and treatment of different musculoskeletal conditions have been published 79 , 80 , 81 , 86 , 87 , 88 , 89 , 90 although efficacy of treatment has not been tested in randomized controlled trials, except in people with chronic low back pain. 84 More randomized controlled trials are needed to assess the efficacy of treatment of MSI syndromes.…”

Section: Discussionmentioning

confidence: 99%

“…Clinicians are able to reliably classify people into MSI syndromes for the lumbar spine, 60 , 62 , 72 , 73 , 74 , 75 even if they have limited clinical experience. 75 , 76 , 77 Kaibafvala et al 78 assessed reliability for the MSI syndromes for the knee region. Kappa values of intra- and inter-rater reliability for judgments of classifications ranged from 0.66 to 0.71, and 0.48 to 0.58, respectively.…”

Section: Msi Syndromes: Validity and Reliability Testingmentioning

confidence: 99%

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Diagnosis and treatment of movement system impairment syndromes

Sahrmann

Azevedo

Dillen

2017

Brazilian Journal of Physical Therapy

572

767

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Section: Discussionmentioning

confidence: 99%

Section: Msi Syndromes: Validity and Reliability Testingmentioning

confidence: 99%

Diagnosis and treatment of movement system impairment syndromes

Sahrmann

Azevedo

Dillen

2017

Brazilian Journal of Physical Therapy

572

767

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“…The intensive training session and the reference manual were used to standardize the examination and decision procedure since these processes were suggested to be e®ective to improve the level of agreements of the movement diagnosis. 10,15 Harris-Hayes and Van Dillen 10 suggested that the speci¯c guideline for each test item in details and explicit rules of classi¯cation, as well as rigorous training were the key for improving the level of reliability. In addition, the strict practice and training of examiners might reinforce the con¯dence of clinical judgments.…”

Section: Discussionmentioning

confidence: 99%

“…Shoulder classi¯cation has nine subcategory syndromes compared with¯ve subcategory syndromes for low back pain [10][11][12] and six subcategory syndromes for knee disorders. [13][14][15] With greater number of subcategory syndromes and inadequate number of subjects presented in each subcategory syndrome, the computed kappa value would be low. Moreover, the reliability is the prerequisite for validity of a classi¯cation system.…”

Section: Discussionmentioning

confidence: 99%

“…The reliability studies of the MSI approach with various study procedures were available on low back pain [10][11][12] and knee pain. [13][14][15] The results showed good to excellent intertester reliability (kappa coe±cients ðKÞ ¼ 0:61-0.71) for low back pain and substantial agreement between raters (K ¼ 0:66-0.71) for knee pain. However, the reliability of using the MSI classi¯cation system to identify the movement impairments in patients with shoulder pain is still lacking.…”

Section: Introductionmentioning

confidence: 92%

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Intertester reliability of a movement impairment-based classification system for individuals with shoulder pain

Torwichien

Vongsirinavarat

Sakulsriprasert

et al. 2020

Hong Kong Physiother. J.

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Background: Other than pathoanatomical diagnosis, physical therapy managements need the diagnosis of movement-related impairments for guiding treatment interventions. The classification system of the Movement System Impairment (MSI) has been adopted to label the musculoskeletal disorders in physical therapy practice. However, reliability study of this classification system in individuals with shoulder pain has not been reported in the literature. Objective: This paper investigated the intertester reliability of the diagnosis based on the MSI classification system in individuals with shoulder pain. Methods: The patients with shoulder pain, between the ages 18–60 years, were recruited if he or she had pain between 30 and 70 on the 100[Formula: see text]mm visual analog scale for at least three months. The examiners who were two physical therapists with different clinical experiences received a standardized training program. They independently examined 45 patients in random order. Each patient was examined by both therapists on the same day. The standardized examination scheme based on the MSI approach was used. Patients were identified to subgroup syndromes according to scapular and humeral syndromes and also determining their subcategory syndromes. Six scapular subcategory syndromes included downward rotated, depressed, abducted, wing, internal rotated[Formula: see text]anterior tilted, and elevated. Three humeral subcategory syndromes were anterior glide, superior glide, and medial rotated. More than one subgroup and subcategory of syndromes could be identified in each patient. The test results of each session were blinded to another therapist. The percentages of agreement and kappa statistic were determined. Results: The results showed that agreement levels in identifying subgroup syndromes was fair [Formula: see text]71.11% agreement, kappa coefficient [Formula: see text] 0.34[Formula: see text] and classifying subcategories syndromes were poor to substantial [Formula: see text]73.33[Formula: see text]91.11% agreement, kappa coefficient [Formula: see text] 0.20[Formula: see text]0.66[Formula: see text]. The overall agreement and kappa value of the MSI classification of subcategory syndromes was poor (kappa coefficient [Formula: see text] 0.11; 95% CI 0.05–0.18[Formula: see text]. The agreement level of subcategories for scapular depression and humeral superior glide syndromes was substantial. The scapular winging, depression, and downward rotation were the three syndromes that were most frequently identified by both the examiners. Conclusion: The intertester reliability between therapists with different experience according to the MSI approach for shoulder pain classification was generally acceptable to poor due to the nature of the classification system. The standardized procedure and intensive training can be used for inculcating novice therapists with adequate level of intertester reliability of examination.

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