Background

The well-known drawer tests to assess glenohumeral laxity and instability have shown appropriate reliability, although analysed mainly in healthy subjects.

Objective

To evaluate the intra- and inter-rater reliability of anterior and posterior drawer tests in subjects with symptoms of shoulder instability.

Design

Clinometric study of intra- and inter-rater reliability of drawer tests was carried out following COSMIN recommendations and GRRAS checklist.

Setting

Centres with equipped facilities for assessments.

Participants

There were 105 participants (69 male/36 female) aged 18 to 60 years with instability symptoms in at least one shoulder. Each participant underwent bilateral assessments. The sample consists of 210 shoulders, unstable and healthy.

Intervention

Anterior and posterior drawer tests.

Main measures

Humeral translations were assessed using drawer tests and graded with Hawkins scale, modified Hawkins and dichotomising (positive/negative). Two sessions were performed (seven to fourteen-day washout period): Each patient was evaluated by two examiners in the first session and by one of them in the second. Weighted Kappa analysed the reliability.

Results

The intra-rater reliability of the anterior and posterior drawer tests was excellent (weighted Kappa = 1) with the Hawkins scale. Inter-rater reliability was good for the anterior drawer: weighted Kappa = 0.76 (95%confidence interval: 0.67–0.85) with the Hawkins scale, weighted Kappa = 0.78 (95%confidence interval: 0.69–0.87) with modified Hawkins, and weighted Kappa = 0.80 (95%confidence interval: 0.71–0.89) dichotomising; and for the posterior drawer: weighted Kappa = 0.62 (95%confidence interval: 0.52–0.72), weighted Kappa = 0.67 (95%confidence interval: 0.57–0.78), and weighted Kappa = 0.70 (95%confidence interval: 0.59–0.80), respectively.

Conclusion

Drawer tests demonstrated excellent intra-rater and good inter-rater reliability in subjects with symptoms of shoulder instability.