{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:30:09Z","timestamp":1793392209718,"version":"4.5.0"},"reference-count":93,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T00:00:00Z","timestamp":1725580800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>There is no established consensus for screening the spine in patients with shoulder pain. The aim of this study was to explore the role of the spine in shoulder pain and generate a set of recommendations for assessing the potential involvement of the spine in patients with shoulder pain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A modified Delphi study was conducted through use of an international shoulder physical therapist\u2019s expert panel. Three domains (clinical reasoning, history, and physical examination) were evaluated using a Likert scale, with consensus defined as Aiken Validity Index \u22650.7.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Twenty-two physical therapists participated. Consensus was reached on a total of 30 items: clinical reasoning (n\u2009=\u20099), history (n\u00a0=\u200913), and physical examination (n\u2009=\u20098). The statement that spinal and shoulder disorders can coexist, sometimes influencing each other and at other times remaining independent issues, along with the concept of radiating pain as an explanatory phenomenon for the spine contribution to shoulder pain, achieved the highest degree of consensus.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>International physical therapists shoulder experts reached consensus on key aspects when screening the spine in people with shoulder pain, including consideration of the distal location of symptoms relative to the shoulder, the presence or previous history of neck pain, the changes in symptoms related to neck movements, and the presence of neuropathic-like symptoms. They also acknowledged the importance of assessing active cervical or cervicothoracic movements and the usefulness of the Spurling test and symptom modification techniques applied to the spine.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Impact<\/jats:title>\n                  <jats:p>This consensus holds implications for both clinical practice and research. In research, applying these considerations may ensure more homogenous samples, thereby enhancing the investigation of outcomes in shoulder pain populations. In clinical practice, determining the need for spine screening and its potential impact on prognosis and management could significantly influence patient care.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ptj\/pzae133","type":"journal-article","created":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T05:57:39Z","timestamp":1725602259000},"source":"Crossref","is-referenced-by-count":13,"title":["Neck or Shoulder? Establishing Consensus for Spine Screening in Patients With Shoulder Pain: An International Modified Delphi Study"],"prefix":"10.1093","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7582-5822","authenticated-orcid":false,"given":"N\u00e9stor","family":"Requejo-Salinas","sequence":"first","affiliation":[{"name":"Department of Physical Therapy , Superior Center for University Studies La Salle, , C\/ La Salle, 10, 28023 Madrid ,","place":["Spain"]},{"name":"Autonomous University of Madrid , Superior Center for University Studies La Salle, , C\/ La Salle, 10, 28023 Madrid ,","place":["Spain"]},{"name":"International Doctoral School, Rey Juan Carlos University , Alcorc\u00f3n ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8365-7264","authenticated-orcid":false,"given":"Rub\u00e9n","family":"Fern\u00e1ndez-Mat\u00edas","sequence":"additional","affiliation":[{"name":"Research Unit, Hospital Universitario Fundaci\u00f3n Alcorc\u00f3n, Alcorc\u00f3n , Calle Budapest 1, 28922 Alcorc\u00f3n, Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Cadogan","sequence":"additional","affiliation":[{"name":"Advance Physiotherapy , 156 Bealey Avenue, Christchurch 8013 ,","place":["New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Chester","sequence":"additional","affiliation":[{"name":"School of Health Sciences , Faculty of Medicine and Health Sciences, , Norwich ,","place":["UK"]},{"name":"University of East Anglia , Faculty of Medicine and Health Sciences, , Norwich ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-S\u00e9bastien","family":"Roy","sequence":"additional","affiliation":[{"name":"Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris) , Qu\u00e9bec City ,","place":["Canada"]},{"name":"Faculty of Medicine, Universit\u00e9 Laval , Qu\u00e9bec City ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip","family":"Struyf","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp , Wilrijk ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Bateman","sequence":"additional","affiliation":[{"name":"Derby Shoulder Unit, University Hospitals of Derby & Burton NHS Foundation Trust , Derby ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Balster","sequence":"additional","affiliation":[{"name":"Melbourne Shoulder Group , Monash University, Prahran, Victoria,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melina Nevoeiro","family":"Haik","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Federal University of S\u00e3o Carlos , S\u00e3o Carlos ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4272-1354","authenticated-orcid":false,"given":"Amee L","family":"Seitz","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy and Human Movement Sciences , Feinberg School of Medicine, , Chicago, Illinois ,","place":["USA"]},{"name":"Northwestern University , Feinberg School of Medicine, , Chicago, Illinois ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leanne","family":"Bisset","sequence":"additional","affiliation":[{"name":"School of Health Sciences and Social Work, Griffith University , Gold Coast ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula Rezende","family":"Camargo","sequence":"additional","affiliation":[{"name":"Laboratory of Analysis and Intervention of the Shoulder Complex , Department of Physical Therapy, , S\u00e3o Carlos, SP ,","place":["Brazil"]},{"name":"Universidade Federal de S\u00e3o Carlos , Department of Physical Therapy, , S\u00e3o Carlos, SP ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Michel","family":"Brism\u00e9e","sequence":"additional","affiliation":[{"name":"Center for Rehabilitation Research, Texas Tech University Health Sciences Center , Lubbock, Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"May","sequence":"additional","affiliation":[{"name":"Independent Physiotherapy Consultant , Sheffield ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Walker","sequence":"additional","affiliation":[{"name":"IG Medical, Ilkley Moor Medical Practice , West Yorkshire ,","place":["England"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Wassinger","sequence":"additional","affiliation":[{"name":"Physical Therapy, East Tennessee State University , Johnston City, Tennessee ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Lenssen","sequence":"additional","affiliation":[{"name":"Melbourne Shoulder Group, Monash University , Prahran, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared K","family":"Powell","sequence":"additional","affiliation":[{"name":"Faculty of Health Science and Medicine , Bond Institute of Health and Sport, , Robina, Queensland ,","place":["Australia"]},{"name":"Bond University , Bond Institute of Health and Sport, , Robina, Queensland ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"McCreesh","sequence":"additional","affiliation":[{"name":"School of Allied Health, University of Limerick , Limerick ,","place":["Ireland"]},{"name":"Ageing Research Centre , Health Research Institute, , Limerick ,","place":["Ireland"]},{"name":"University of Limerick , Health Research Institute, , Limerick ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo","family":"Gibson","sequence":"additional","affiliation":[{"name":"Rehab4Performance , Liverpool ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula M","family":"Ludewig","sequence":"additional","affiliation":[{"name":"Division of Rehabilitation Science , Dept. of Rehabilitation Medicine, , Minneapolis, Minnesota ,","place":["USA"]},{"name":"University of Minnesota , Dept. of Rehabilitation Medicine, , Minneapolis, Minnesota ,","place":["USA"]},{"name":"Division of Physical Therapy , Dept. of Rehabilitation Medicine, , Minneapolis, Minnesota ,","place":["USA"]},{"name":"University of Minnesota , Dept. of Rehabilitation Medicine, , Minneapolis, Minnesota ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"La Touche","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy , Superior Center for University Studies La Salle, , C\/ La Salle, 10, 28023 Madrid ,","place":["Spain"]},{"name":"Autonomous University of Madrid , Superior Center for University Studies La Salle, , C\/ La Salle, 10, 28023 Madrid ,","place":["Spain"]},{"name":"Neuroscience and Craneofacial Pain Institute (INDCRAN) , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"Lluch-Girb\u00e9s","sequence":"additional","affiliation":[{"name":"Physiotherapy in Motion , Multi-Speciality Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, , Valencia ,","place":["Spain"]},{"name":"University of Valencia , Multi-Speciality Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, , Valencia ,","place":["Spain"]},{"name":"Pain in Motion International Research Group, Vrije Universiteit Brussel , 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