Hand searching of journals yielded one eligible study while one expert provided another. In total, 17 studies Modulators fulfilled all inclusion criteria (Figure 1). The included studies are summarised in Table 1. Seven studies investigated inter-rater reliability of measurement of passive hip movements (Aalto et al 2005, Chevillotte et al 2009, Cibere et al 2008, Croft et al 1996, Currier et al 2007, Sutlive et al 2008, Van Gheluwe et al 2002), seven investigated knee movements (Cibere et al 2004, Cleffken et al 2007, Currier et al 2007, Fritz et al 1998, Hayes & Petersen 2001, Rothstein et al

1983, Watkins et al 1991), five investigated Ibrutinib ankle movements (Diamond et al 1989, Elveru et al 1988, Erichsen et al 2006, Smith-Oricchio & Harris 1990, Van Gheluwe et al 2002), and one investigated first ray movements (Van Gheluwe et al 2002). In 11 studies physiotherapists acted as raters. There

were no disagreements between reviewers on selection of studies. The methodological quality of included studies is presented in Table 2. One study (Smith-Oricchio & Harris 1990) fulfilled all four criteria for external validity and four studies (Cibere et al 2008, Elveru et al 1988, Hayes and Petersen 2001, Watkins et al 1991) satisfied three criteria. Two studies (Cibere et al 2004, Watkins et al 1991) fulfilled all three criteria for internal validity representing Afatinib price a low risk of bias, while five studies (Cibere et al 2008, Diamond et al 1989, Elveru et al 1988, Fritz et al 1998, Smith-Oricchio and Harris 1990) satisfied two criteria. Items on external and internal validity could not be scored on 48/153 (31%) occasions because of insufficient reporting. On methodological quality scores, 12/170 (7%) disagreements occurred between reviewers which were all resolved by discussion. The inter-rater reliability for measurement of physiological Ketanserin range of

motion is presented in Table 3 and for physiological end-feel in Table 4. Because of clinical and methodological heterogeneity between studies, we did not attempt to calculate pooled estimates of reliability. Hip (n = 7): None of the studies fulfilled all criteria for external or internal validity. In two studies ( Aalto et al 2005, Cibere et al 2008), acceptable reliability was reached. Inter-rater reliability (ICC) of measurements of passive physiological range of motion ranged from 0.12 (95% CI 0.00 to 0.35), for surgeons and a physician assistant using vision to measure extension in preoperative patients with hip osteoarthritis ( Chevillotte et al 2009), to 0.91, for physiotherapists using a goniometer to measure internal rotation in non-symptomatic participants ( Aalto et al 2005). Chevillotte and colleagues (2009) found unacceptable reliability for measurements of all physiological hip movements. However, their estimates could have been underestimated due to instability of characteristics of participants as well as of raters.