Reliability of Interpretation of The Paris Classification of Normal End Feel for Elbow Flexion and Extension

Identification of the anatomic and pathoanatomic structure which limits the range of motion of a joint help to determine the need for and type of treatment approach. The purpose of this study was to determine the interrater and intrarater reliability of two experienced physical therapists in the identification of the type of end feel for elbow flexion and extension when using the Paris classification system of normal end feel. Four trials of flexion end feel and four trials of extension end feel were conducted for each of the twenty subjects by each blindfolded examiner. A total of 160 movements were performed by each examiner. The intertester Kappa value for interrater reliability for flexion was .40 and for extension was .73 with a significance of p < .0001 for both flexion and extension. Intrarater agreement was measured by percent comparison. Examiner A demonstrated 80% agreement for flexion and 79% for extension. Examiner B showed 75% agreement for flexion and 78% for extension. This study demonstrated a fair to good level of reliability of interpretation of elbow end feel assessment in a non clinical setting.