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Assessment and Diagnosis of Musculoskeletal Shoulder Disorders over the Internet

DOI: 10.1155/2012/945745

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Shoulder disorders are common, debilitating, and represent a considerable burden on society. As primary contact practitioners, physiotherapists play a large role in the management and rehabilitation of people with these conditions. For those living outside of urban areas, however, access to physiotherapy can be limited. The aim of this study was to evaluate the validity and reliability of using a telerehabilitation system to collect physical examination findings and correctly identify disorders of the shoulder. Twenty-two participants with 28 shoulder disorders were recruited and underwent a face-to-face physical examination and a remote telerehabilitation examination. Examination findings and diagnoses from the two modes of assessment were used to determine validity and reliability of the new method. Diagnostic agreement and agreement on individual findings between the two methods were found to be consistent with the reliability of conventional assessment methods. This study provides important preliminary findings on the validity and reliability of musculoskeletal examinations conducted via telerehabilitation. 1. Introduction Shoulder pain is common in society, with 7%–27% of the adult population experiencing shoulder pain at any one time, and 7%–67% of people experiencing shoulder pain in their lifetime [1]. Of first episode shoulder pain clients, 50% will continue to have symptoms 18 months later [2], making shoulder pain the third most common reason for primary care consultation, after back and neck complaints [3]. Accurate and effective assessment and treatment of shoulder conditions is therefore important to health care practitioners. Physiotherapists often assess and treat clients with shoulder pain, and there exists considerable evidence of effective physiotherapy treatments for many shoulder disorders [3–8], with conservative physiotherapy management shown to provide up to an 88% improvement in shoulder function in the long term [9]. Unfortunately, people living in rural and remote areas of Australia have limited access to physiotherapy services, a phenomenon observed also in the USA [10–12]. Telerehabilitation, the provision of rehabilitation services via the internet, is one potential service delivery model which may improve access to physiotherapy services in rural and remote areas. However, relatively little research has been conducted into the validity and reliability of telerehabilitation for the assessment and treatment of musculoskeletal disorders [13, 14]. To establish the concurrent validity of such services, research must prove that


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