Seated Single-Arm Shot-Put Test to Measure the Functional Performance of the Upper Limbs in Exercise Practitioners With Chronic Shoulder Pain: A Reliability Study

Goniometry and fleximetry measurements to assess cervical range of motion in individuals with chronic neck pain: a validity and reliability study

PURPOSE

To assess the test-retest and inter-rater reliability of goniometry and fleximetry in measuring cervical range of motion in individuals with chronic neck pain.

METHODS

A reliability study. Thirty individuals with chronic neck pain were selected. Cervical range of motion was measured by goniometry and fleximetry at two time points 7 days apart. To characterize the sample, we used the numerical pain rating scale, Pain-Related Catastrophizing Thoughts Scale, and Neck Disability Index. Intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimum detectable change (MDC) were calculated. Correlations between goniometry and fleximetry measurements were performed using Spearman's correlation coefficient (rho).

RESULTS

For goniometry, we found excellent test-retest reliability (ICC ≥ 0.986, SEM ≤ 1.89%, MDC ≤ 5.23%) and inter-rater reliability (ICC ≥ 0.947, SEM ≤ 3.91%, MDC ≤ 10.84%). Similarly, we found excellent test-retest reliability (ICC ≥ 0.969, SEM ≤ 2.71%, MDC ≤ 7.52%) and inter-rater reliability (ICC ≥ 0.981, SEM ≤ 1.88%, MDC ≤ 5.20%) for fleximetry. Finally, we observed a strong correlation between the goniometry and the fleximetry for all cervical movements (rho ≥ 0.993).

CONCLUSION

Goniometry and fleximetry measurements are reliable for assessing cervical range of motion in individuals with chronic neck pain.

Measurement properties of upper extremity physical performance tests in athletes: a systematic review

BACKGROUND

Upper extremity Physical Performance Tests (PPTs) have been used in sports contexts to provide functional status of the athletes. However, whether these tests present appropriate measurement properties to be considered a valuable measurement is not clear.

OBJECTIVE

To systematically review the measurement properties of upper extremity PPTs in athletes.

METHODS

Databases (e.g., Medline, EMBASE, CINAHL, SPORTDiscus, CENTRAL) were searched in March 2021. Two reviewers independently rated the methodological quality using the 4-point Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. Quality of evidence was graded by measurement property for each test, considering the adequacy, the sample size, and the methodological quality of the studies.

RESULTS

Fifteen studies were included with a pooled sample of 684 athletes. The PPTs analyzed were Arm-Jump Board Test, Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), Finger Hang Test, Medicine Ball Explosive Power Test, One-Arm Hop Test, Posterior Shoulder Endurance Test, Pull-Up Shoulder Endurance Test, Repetition to Failure Assessment, Seated Medicine Ball Throw Test (SMBT), Seated Single-Arm Shot-Put Test (SSPT), Shoulder Endurance Test, Two-Arm Bent Hang Test, Unilateral Seated Shot-Put Test, and Upper Limb Rotation Test. Evidence synthesis provided moderate and high-quality evidence for sufficient inter-session and intra-session reliability of the CKCUEST, respectively. There was moderate evidence for sufficient inter-session reliability of the SSPT and for insufficient validity of the SMBT.

CONCLUSION

The CKCUEST and the SSPT are sufficiently reliable in athletes. More studies are needed to investigate other psychometric properties for these tests and other upper extremity PPTs.

Unilateral seated shot-put test, muscle strength, and range of motion on recreational athletes with chronic shoulder pain: Cross-sectional study

OBJECTIVE

To correlate the functional performance assessed by means of the Unilateral Seated Shot-Put Test (SSPT) with shoulder muscle strength, range of motion (ROM), and handgrip strength in recreational athletes with chronic shoulder pain.

METHODS AND MATERIALS

The sample was composed of recreational athletes with nonspecific pain in the dominant shoulder ≥3 months, both sexes, aged between 18 and 45 years. We diagnosed shoulder pain by reporting pain intensity ≥3 points on the Numerical Rating Pain Scale and used the Shoulder Pain and Disability Index, Pain-Related Catastrophizing Thoughts Scale, and Baecke Questionnaire. Moreover, shoulder muscle strength, handgrip strength, ROM, and functional performance using the SSPT were evaluated. We used the Spearman correlation coefficient to investigate the correlation between the variables.

RESULTS

Nineteen participants were included. Most of the sample consisted of adult women with adequate body mass and pain predominantly in the right shoulder. We observed higher correlation magnitudes of the SSPT with handgrip strength (rho = 0.818 to 0.833, p < 0.05). Correlations of the SPPT with shoulder musculature strength were of low to moderate magnitude (rho = 0.461 to 0.672, p < 0.05). The only significant correlation (p < 0.05) found was between the SSPT and ROM (horizontal adduction), however, with a weak magnitude (rho <0.50).

CONCLUSION

SSPT correlates strongly with handgrip strength and moderately with shoulder muscle strength in recreational athletes with chronic shoulder pain.

Performance, Test-retest Reliability, and Measurement Error of the Upper Limb Seated Shot Put Test According to Different Positions of Execution

BACKGROUND

The unilateral Seated Shot-Put Test (USSPT) is an easy to apply, inexpensive tool that can be used to assess shoulder performance unilaterally. Two different positions of execution have been described in previous studies, however, differences regarding reference values and psychometric properties were not assessed.

PURPOSE

To investigate the performance, test-retest reliability and measurement error of the USSPT according to different positions of execution (floor versus chair) in overhead athletes. The hypothesis was that both positions would present similar values, good to excellent test-retest reliability and clinically acceptable measures.

STUDY DESIGN

Test-retest reliability.

METHODS

Forty-four overhead athletes performed the USSPT on the floor (USSPT-F) and on a chair (USSPT-C). Normative values were established according to gender, age, and dominance. Test-retest reliability was determined using Intraclass Correlation Coefficient and measurement error through Standard Error of Measurement, Smallest Detectable Change, as well as Bland and Altman plots.

RESULTS

Reference values for both positions were provided. Women performed better on the USSPT-C than USSPT-F. Excellent test-retest reliability 0.97 (0.89 - 0.99) for dominant side and 0.95 (0.80 - 0.98) for non-dominant side was found for the USSPT-F. Moderate to excellent reliability 0.91 (0.67 - 0.98) for dominant side and 0.74 (0.01 - 0.93) for non-dominant side was found for the USSPT-C. Presence of systematic error (14.76 cm) was found only for USSPT-C dominant (p=0.011).

CONCLUSION

Differences were found only for women with better performance on the USSPT-C. The USSPT-F presented higher reliability values. Both tests presented clinically acceptable measures. Presence of systematic error was found only in the USSPT-C.

LEVEL OF EVIDENCE

3.

Reliability of Upper Extremity Functional Performance Tests for Overhead Sports Activities

Background

There is lack of consensus on which tests, particularly upper extremity functional performance tests (FPT) that should be used for clinical decision making to progress a patient through a rehabilitation program or criteria for return to sport (RTS). Consequently, there is a need for tests with good psychometric properties that can be administered with minimal equipment and time.

Purpose

(1) To establish the intersession reliability of several open kinetic chain FPT in healthy young adults with a history of overhead sport participation. (2) To examine the intersession reliability of the limb symmetry indices (LSI) from each test.

Study Design

Test-retest reliability, single cohort study.

Methods

Forty adults (20 males, 20 females) completed four upper extremity FPT during two data collection sessions three to seven days apart: 1) prone medicine ball drop test 90°shoulder abduction (PMBDT 90°), 2) prone medicine ball drop test 90°shoulder abduction/90° elbow flexion (PMBDT 90°-90°), 3) half-kneeling medicine ball rebound test (HKMBRT), 4) seated single arm shot put test (SSASPT). Measures of systematic bias, absolute reliability and relative reliability were computed between the sessions for both the original test scores and LSI.

Results

Except for the SSASPT, all tests demonstrated significant (p ≤ 0.030) improvements in performance during the second session. Generally, for the medicine ball drop/rebound tests, the absolute reliability was the highest (less random error) for the HKMBRT, next the PMBDT 90°followed by PMBDT 90°-90°. Excellent relative reliability existed for the PMBDT 90°, HKMBRT, and SSASPT, whereas fair to excellent relative reliability for the PMBDT 90°-90°. The SSASPT LSI revealed the highest relative and absolute reliability.

Conclusion

Two tests, HKMBRT and SSASPT demonstrated sufficient reliability; therefore, the authors' recommend those tests can be used for serial assessments to advance a patient through a rehabilitation program as well as criteria for progression to RTS.

Level of Evidence

3.

Limb Dominance Effects on Seated Single-Arm Shot-Put Limb Symmetry Indices Following Shoulder Rehabilitation

CONTEXT

Typically, most clinical return to activity guidelines recommend that an injured shoulder achieve a 90% to 100% functional performance test limb symmetry index (LSI); however, as previous research demonstrated a 103% to 111% dominant limb bias in seated single-arm shot-put test (SSASPT) performance, the typical criteria might not be appropriate for interpreting SSASPT LSI. Thus, the current objective was to evaluate SSASP LSI differences between dominant and nondominant involved shoulders and to determine how many patients met the suggested 90% to 100% LSI criteria, as well as the 103% for dominant (89% for nondominant) normative SSASPT threshold reported in the literature, at the time of discharge.

DESIGN

Cross-sectional.

METHODS

Patients with shoulder injury or surgery (n = 78) completed the SSASPT at the time of discharge from rehabilitation and were grouped according to whether the involved shoulder was the dominant (n = 42) or nondominant (n = 32) limb. LSI (involved/uninvolved × 100) was computed from the average of 3 SSASPT trial distances completed with each limb.

RESULTS

The LSI for the nondominant involved group (88.9% [12.4%]) was significantly less (confidence intervalDiff, -12.1% to -22.1%) than the dominant involved group (106.0% [9.3%]). While 95.2% of patients in the dominant involved group exhibited LSI > 90%, only 43.8% of patients in the nondominant involved group attained LSI > 90%. Across the entire cohort, the odds of a nondominant involved LSI being below the respective SSASPT normative range were 2.04 (95% confidence interval, 0.80-5.21) times higher than the odds of a dominant involved LSI being below the normative range.

CONCLUSIONS

Patients with dominant limb involvement exhibited higher LSI than patients with nondominant limb involvement at discharge from rehabilitation. Particularly when the nondominant shoulder is involved, these results suggest that patients with shoulder injury and surgery may require longer rehabilitation to attain higher levels of upper-extremity function.

Relationships between the seated single arm shot put test and Quick-DASH in patients being discharged from physical therapy

BACKGROUND

Research examining the relationship between patient reported outcomes (PRO) and upper extremity functional performance tests (UEFPT) in patients with shoulder pathology are limited.

OBJECTIVE

To assess the relationship between the seated single arm shot put test (SSASPT) and the PRO Quick-Disabilities of Arm, Shoulder, and Hand (DASH) in patients being discharged from physical therapy after shoulder injury or surgery.

METHODS

Six physical therapists who regularly use the SSASPT and DASH from six different clinical sites provided SSASPT scores and completed Quick-DASH forms on 75 patients being discharged from rehabilitation following shoulder injury or surgery. Patients were grouped according to whether the involved shoulder was the dominant (n = 43) or nondominant (n = 32) limb. Three separate simple linear regression models, whole cohort and two patient groups, were created to determine the magnitude of the relationships (standardized betas) and change (betas) between DASH scores and the SSASPT limb symmetry index (LSI).

RESULTS

Neither whole cohort nor two groups exhibited statistically significant (P > .05) relationships between LSI and Quick-DASH scores based upon the standardized betas (-0.197-0.038). Additionally, neither the standardized betas (z = 1.49, P = .135) nor betas (z = 1.28, P = .200) were statistically different between the two groups.

CONCLUSIONS

The current study revealed no association between SSASPT and the Quick-DASH at discharge from physical therapy following shoulder injury or surgery. Consequently, it may be important to perform a battery of tests that include both subjective PRO and objective UEFPT tests to obtain a comprehensive perspective of the patient's functional and perceived status.

Intra- and intersession reliability and agreement of the Unilateral Seated Shot-Put Test outcome measures in healthy male athletes

BACKGROUND

The Unilateral Seated Shot-Put Test (USSPT) consists of pushing an overweight ball as far as possible to assess upper extremity power unilaterally and bilateral symmetry. Literature however reports various body positions and upper limb pushing patterns to perform USSPT, demanding to provide additional guideline to achieve overweight ball push. This study therefore aimed at assessing the reliability and agreement of USSPT outcome measures when pushing an overweight ball in a horizontal direction.

METHODS

Twenty-seven healthy male athletes performed two sessions, one week apart, of three unilateral pushes per upper limb using a 3-kg medicine ball, for which the distances were measured. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimum detectable change at a 95 % confidence level (MDC_95 %) and coefficient of variation (CV) were assessed for the pushing distances based on one, two or three trials per side to produce two outcome measures: the pushing distance per limb and USSPT Limb Symmetry Index (LSI) when dividing pushing distance of the dominant side by that of the non-dominant side.

RESULTS

The most reliable pushing distance per limb was obtained when averaging three pushing distances, normalized by body mass with the exponent 0.35. The mean USSPT LSI was 1.09 ± 0.10 for the first session and 1.08 ± 0.10 for the second session, highlighting good reliability and agreement (ICC = 0.82; SEM = 0.045; MDC_95 % = 0.124; CV = 5.02 %).

CONCLUSIONS

When the overweight ball is pushed in a horizontal direction, averaging the distances of three trials for both the dominant and non-dominant limbs is advised to provide the most reliable USSPT distance per limb and USSPT LSI.