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Open AccessArticle

Inter-and Intra-Examiner Reliability of Supraspinatus Muscle Tendon Palpation: A Cross-Sectional Study by Ultrasonography

Physiotherapy and Pain Group, Department of Physical Therapy, University of Alcala, Alcalá de Henares, 28871 Madrid, Spain
Instituto de Investigación Fisioterapia y Dolor, University of Alcala, Alcalá de Henares, 28805 Madrid, Spain
CARMASALUD Clinical and Research Center, 28037 Madrid, Spain
Department of Physical Therapy and Podiatry, Faculty of Health, Exercise and Sport, European University of Madrid, 28670 Madrid, Spain
Department of Biomedical Sciences, Medicine and Physiotherapy, Faculty of Physiotherapy, Universidade da Coruña, 15006 A Coruña, Spain
MODES group, CITIC, Department of Mathematics, Faculty of Sciences, Universidade da Coruña, 15008 A Coruña, Spain
Author to whom correspondence should be addressed.
Medicina 2020, 56(2), 83;
Received: 31 December 2019 / Revised: 10 February 2020 / Accepted: 14 February 2020 / Published: 18 February 2020
(This article belongs to the Special Issue Ultrasound in Sports Medicine: Current Concepts and Advances)
Background and objectives: Palpation is an inherent and basic skill of health professionals—particularly manual therapists who base their diagnosis and treatment in a clinical environment. Many authors have previously described multiple palpation positions for supraspinatus muscle tendon (SMT); however, there are no current studies that evaluate palpation concordance reliability for the SMT in this particular position. This study aimed to investigate the intra- and inter-rater reliabilities of supraspinatus muscle tendon (SMT) palpation. Materials and Methods: Thirty-six healthy participants (14 females; aged 22–35 years) were recruited. Musculoskeletal ultrasound was used to measure the SMT localization after two physiotherapists performed the SMT palpation at two different times. The distance between the two marked points was used to analyze the analysis of true agreement between examiners. Finally, we analyzed if the demographic variables influenced the palpation procedure. Results: The intra-examiner reliability showed a high percentage of concordance for examiner 1 (E.1) (first palpation procedure (P.1) = 91.7%: second palpation procedure (P.2) = 95.8%) and examiner 2 (E.2) (P.1 = 91.6%; P.2 = 97.2%) and high percentage of inter-palpation agreement for E.1 (87.5%) and E.2 (88.9%). The inter-examiner reliability showed a high total concordance for the right shoulder (E.1 = 94.4%; E.2 = 95.8%) and left shoulder (E.1 = 93.05%; E.2 = 95.05%). The agreement (%) according to both examiners was 93.05% for the right shoulder and 94.4% for the left shoulder. The agreement between both examiners and the ultrasound (% of true agreement) was 92.9% for the right shoulder and 92.8% for the left shoulder. A statistically significant association (p = 0.02) was found for weight regarding concordance reliability; this was not seen for dominant arm, age, gender, body mass index, height, and tendon depth (p > 0.05). Conclusions: The SMT palpation technique showed a high level of concordance and reproducibility. View Full-Text
Keywords: shoulder; rotator cuff; ultrasound imaging; palpation; reliability shoulder; rotator cuff; ultrasound imaging; palpation; reliability
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Naranjo-Cinto, F.; Falcon-Machado, G.; Garrido-Marin, A.; Senin-Camargo, F.J.; Jacome-Pumar, M.A.; Fernandez-Matias, R.; Pecos-Martin, D.; Gallego-Izquierdo, T. Inter-and Intra-Examiner Reliability of Supraspinatus Muscle Tendon Palpation: A Cross-Sectional Study by Ultrasonography. Medicina 2020, 56, 83.

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