Background: The Neer, Hawkins, and Yocum clinical tests detect sub-acromial impingement as a pathogenic process of degenerative rotator cuff disease. Their reproducibility has been little investigated.
Objectives: We tested the reproducibility of the Neer, Hawkins, and Yocum clinical tests for detecting this sub-acromial impingement and also an original clinical manoeuver, the countertest with elevation with lateral rotation (CELR), which is a test of sub-acromial impingement.
Methods: Patients with shoulder pain due to degenerative rotator cuff disease were prospectively included. They were assessed with the Neer, Hawkins and Yocum tests as well as the CELR twice at a 1 week interval. Intra- and inter-observer reproducibility was assessed by percentage agreement and the kappa coefficient of concordance with 95% confidence intervals (CIs). Concordance was poor with kappa ≤0.4, moderate >0.4, and good >0.61. It was considered suitable for clinical use with kappa >0.4.
Results: We included 34 patients (mean [SD] age 60 [11] years; 26 females). For intra-observer reproducibility, agreement was 80% to 88%. By the kappa coefficient, intra-observer reproducibility was poor for the Neer test and moderate for the Hawkins test (0.56 [95% CI 0;0.9]) and Yocum test (0.48 [0;0.8]) and CELR (0.6 [0.2;0.9]). For inter-observer reproducibility, agreement was 73% to 88%. By the kappa coefficient, inter-observer reproducibility was poor for the Yocum test, moderate for the Hawkins test (0.54 [0.2;0.8]) and CELR (0.58 [0.2;0.8]), and good for the Neer test (0.64 [0.2;0.9]).
Conclusion: The Hawkins test and CELR had a balanced profile of reproducibility suitable for clinical practice. We underline the potential interest of CELR, an original manoeuver.
Keywords: Clinical test; Degenerative rotator cuff disease; Reproducibility; Sub-acromial impingement.
Copyright © 2018. Published by Elsevier Masson SAS.