The Shoulder Symptom Modification Procedure (SSMP): A Reliability Study
Hilla Sarig Bahat and Orna Kerner
Setting the scene:
Shoulder pain is a common musculoskeletal problem, the causes of shoulder pain include rotator cuff (RC) disorders, glenohumeral joint (GHJ) disorders, acromioclavicular joint (ACJ) disorders and referred neck pain. Diagnosing the underlying structures responsible for shoulder symptoms is difficult as clinical features are similar and current assessment techniques have poor reliability. The Shoulder Symptom Modification Procedure (SSMP) was developed by to potentially provide an alternative approach for shoulder assessment. The aim of this study was to investigate the intra- and inter-tester reliability of the SSMP in patients with shoulder pain.
What did they do?
115 patients with shoulder pain participated in the study. In the intra-tester reliability study, one physiotherapist (tester 1) assessed 25 subjects twice, while the inter-tester reliability study involved three qualified physiotherapists, assessing 90 participants with shoulder symptoms. Inter-tester assessments were conducted in three blocks of 30 patients; each underwent two assessments by two physiotherapists: tester 1 and 2, 1 and 3, and 2 and 3. Each evaluation took approximately 40 minutes, with a wash out period of 20-40 minutes to allow for symptoms to return to baseline levels between the sessions. Agreement was established when two repeated tests achieved a positive (>_ 30%) or negative (<30 %) value in each category. The results showed that the intra-tester reliability of the SSMP test for the 4 main categories ranged between moderate to substantial and the reliability for inter-tester ranged between poor to almost perfect.
Takeaway message:
The Shoulder Symptom Modification Procedure (SSMP) can be a reliable method in assessing patients with shoulder problems.