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Kim TG, Kim YH, Ma R, Kim SY. Scapula position test reliability and comparisons of scapula position and shoulder function among individuals with and without adolescent idiopathic scoliosis. J Back Musculoskelet Rehabil 2024:BMR230357. [PMID: 39093062 DOI: 10.3233/bmr-230357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
BACKGROUND An evaluation of scapula position is important to predict spine curvature and shoulder function in patients with adolescent idiopathic scoliosis (AIS). Therefore, a reliable scapula position is required to assess posture in patients with AIS. OBJECTIVE This study investigated the reliabilities of scapula position tests and differences in scapula position and shoulder function between individuals with and without AIS. METHODS The study compared 18 patients with AIS and 18 healthy controls to identify differences in scapula position and shoulder function. The acromion-table distance, lateral displacement of the scapula, acromion depression, winged scapula, upward rotation of the scapula, and anterior tilt of the scapula were measured. Scapula position test reliabilities were assessed using the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimum clinically important difference (MCID). Shoulder function was measured using the Shoulder Pain and Disability Index. RESULTS The reliabilities of scapula position tests (ICC 0.85-0.93, SEM 0.1-1.2, and MCID 0.2-2.5) were good. There were significant differences in scapula position and shoulder function between patients with AIS and healthy controls (p< 0.05). CONCLUSION Scapula position tests were highly reliable in patients with AIS; they can be used to evaluate scapula position during clinical assessment of posture in patients with AIS.
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Affiliation(s)
- Tae-Gyu Kim
- Major of Marine-Sports, Division of Smart Healthcare, Pukyong National University, Busan, Korea
| | - Young-Hoon Kim
- Major of Marine-Sports, Division of Smart Healthcare, Pukyong National University, Busan, Korea
| | - Rui Ma
- Department of Physical Education, Henan Agricultural University, Zhengzhou, China
| | - Soo-Yong Kim
- Department of Physical Therapy, Pusan National University Yangsan Hospital, Yangsan, Korea
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Della Tommasina I, Trinidad-Morales A, Martínez-Lozano P, González-de-la-Flor Á, Del-Blanco-Muñiz JÁ. Effects of a dry-land strengthening exercise program with elastic bands following the Kabat D2 diagonal flexion pattern for the prevention of shoulder injuries in swimmers. Front Physiol 2023; 14:1275285. [PMID: 38028779 PMCID: PMC10679734 DOI: 10.3389/fphys.2023.1275285] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/02/2023] [Indexed: 12/01/2023] Open
Abstract
Background: During the repetitive execution of the swimming strokes, the muscles responsible for the internal rotations of the shoulders tend to become stronger compared to the muscles that oppose these movements. The aim of this study was to analyse the effect of a strengthening program for the shoulder rotator muscles using elastic band exercises in a diagonal Kabat pattern (D2 for flexion) in swimmers, to develop an effective, quick and easy-to-implement protocol for preventive training routines. Methods: A randomized controlled trial design was carried out. Internal and external rotation range of movement, isometric strength of the muscles responsible for internal and external rotation of the shoulder, scapular movements, was measured at the beginning of the study and after 8 weeks post-intervention. A total of 22 male swimmers participated in the study and were randomly assigned to either an experimental group (n = 11) or a control group (n = 11). The experimental group underwent a 8-week shoulder-strength program using elastic bands, while the control group focused on aquatic training. Results: The strength-training program resulted in an improvement in the isometric strength of the muscles responsible for external rotation and a better balance between the shoulder rotator muscles in the experimental group. However, these improvements have not been significant (p > 0.05). Conclusion: The strengthening exercise program showed minimal improvement in shoulder rotation strength and range of motion. These findings suggest that the prescribed shoulder-strengthening exercise could be a quick-beneficial dry-land training option to improve external rotation shoulder strength or range of motion, but more studies with larger sample sizes and more weeks of treatment are needed to determine the efficacy of this protocol.
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Affiliation(s)
- Ivan Della Tommasina
- Faculty of Physical Activity and Sport Sciences, European University of Madrid, Madrid, Spain
| | | | - Pedro Martínez-Lozano
- Faculty of Physical Activity and Sport Sciences, European University of Madrid, Madrid, Spain
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Ellenbecker T, Roetert EP, Petracek K, Kovacs M, Barajas N, Bailie D. Bilateral Comparison of Anterior Shoulder Position in Elite Tennis Players. Int J Sports Phys Ther 2022; 17:863-869. [PMID: 35949371 PMCID: PMC9340837 DOI: 10.26603/001c.36629] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 04/09/2022] [Indexed: 12/02/2022] Open
Abstract
Background In elite tennis players, musculoskeletal adaptations in the dominant upper extremity have been reported for range of motion, strength, and scapular biomechanics. In addition to scapular dysfunction, tightness and inflexibility of the pectoral musculature have been identified as risk factors for the development of overuse shoulder injury in overhead athletes. Hypothesis Differences in anterior shoulder position will be identified between the dominant and non-dominant extremity in elite tennis players. The purpose of this study was to examine bilateral differences in anterior shoulder posture measured using a double square in elite tennis players without shoulder injury. Study Design Descriptive Laboratory Study. Methods Three hundred and six uninjured elite tennis players were measured in the supine position using a double square method to measure anterior shoulder position. The distance from the surface of the table to the anterior most position of the shoulder (in millimeters) was measured bilaterally and compared. A dependent t-test was used to test for significant differences in anterior shoulder position between the dominant and non-dominant extremity. Results One hundred thirty-three males and 173 females were included in this study with a mean age of 16.58 years. The mean difference between extremities indicates increased anterior shoulder positioning on the dominant shoulder of 7.65 mm in females, and 8.72 in males. Significantly greater (p<.001) anterior shoulder position measures were documented on the dominant shoulder as compared to the non-dominant shoulder. Conclusions The results of this study showed significantly (p<.001) greater anterior shoulder position on the dominant extremity of elite male and female tennis players. The differences of 7-8mm between extremities has clinical application for interpreting anterior shoulder position test results in this population. Level of Evidence 3.
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Affiliation(s)
- Todd Ellenbecker
- Rehab Plus Sports Therapy Scottsdale, AZ, USA; Vice President Medical Services, ATP Tour, Scottsdale, AZ, USA
| | - E Paul Roetert
- Managing Director of USTA University, United States Tennis Association, Orlando, FL, USA
| | | | - Mark Kovacs
- International Tennis Performance Association, Atlanta, GA, USA; Kovacs Institute, Atlanta, GA, USA
| | | | - David Bailie
- Arizona Institute for Sports Knees & Shoulders, Scottsdale, AZ, USA
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Outcomes of scapulothoracic mobilisation in patients with neck pain and scapular dyskinesis: A randomised clinical trial. J Taibah Univ Med Sci 2021; 16:540-549. [PMID: 34408611 PMCID: PMC8348581 DOI: 10.1016/j.jtumed.2021.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 03/18/2021] [Accepted: 03/22/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives The perceived outcomes of scapulothoracic mobilisation with movement (MWM) in patients with neck pain and scapular dyskinesis remain unclear. This study aimed to examine the effects of adding scapulothoracic MWM to the corrective exercise and taping regimen in patients with neck pain and scapular dyskinesis. Methods Forty participants with neck pain and scapular dyskinesis were randomly assigned to one of two 3-week regimens: experimental (scapulothoracic MWM + corrective exercises + tape) or comparison (corrective exercises + tape). The visual analogue scale, pressure pain threshold (PPT), cervical and scapular range of motion (ROM), and neck disability index (NDI) were measured at the start and after the third and sixth sessions. Results Pain decreased after the sixth session in both experimental (mean difference: 3.1; 95% confidence interval [CI]: 2.1–4.1) and comparison (mean difference: 1.8; 95% CI: 0.81–2.8) groups. Although there was no change in PPT and scapular ROM, scapular upward rotation decreased significantly only in the comparison group in the sixth session (p = 0.014). The ROM for neck extension, right rotation, and right and left side bending improved significantly (p ≤ 0.031) in both groups. The NDI improved in both the experimental (mean difference: 7.2–10.6; 95% CI: 2.5–15.7) and comparison (mean difference: 5.9–10.3; 95% CI: 1.2–15.4) groups. There were no significant differences in outcomes between the groups. Conclusions In this study, the addition of scapulothoracic MWM to the corrective exercise and taping regimen over a 3-week period did not increase pain or improve function in patients with neck pain and scapular dyskinesis.
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Paraskevopoulos E, Papandreou M, Gliatis J. Reliability of assessment methods for scapular dyskinesis in asymptomatic subjects: A systematic review. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2020; 54:546-556. [PMID: 33155568 DOI: 10.5152/j.aott.2020.19088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this systematic review was to evaluate the available published evidence on the intra- and inter-rater reliabilities of assessment methods used for identifying and measuring scapular dyskinesis (SD) in asymptomatic subjects. METHODS A systematic electronic literature search was performed in PubMed, Physiotherapy Evidence Database, Scopus, and the Cochrane Library, and studies on the intra- and inter-rater reliabilities of physical examination tests used for identifying SD in asymptomatic people were identified. Methodological quality of the studies meeting the inclusion criteria was assessed using the Quality Appraisal of Reliability Studies (QAREL) checklist by two reviewers. The overall level of evidence of this systematic review was determined by the Modified Cochrane Back Pain Criteria based on previous research which was modified for reliability studies of the shoulder complex. RESULTS The literature search generated 388 results, and only 14 articles met the inclusion criteria. In these studies, reliabilities of two qualitative and five quantitative methods for the assessment of SD were analyzed. The QAREL checklist revealed that 12 studies had moderate risk of bias and 2 had high risk of bias. Additionally, none of the studies were of high quality. On the basis of the Modified Cochrane Back Pain Criteria, the overall level of evidence was moderate. Most of the studies including quantitative measurement methods found good to excellent inter- and intra-rater reliability values. Most of the studies including qualitative methods found low-to-moderate intra- and inter-rater reliability values. CONCLUSION Considering the available published evidence, there is lack of high-quality studies evaluating the inter- and intra-rater reliabilities of qualitative or quantitative methods used for the assessment of SD. There are no qualitative methods with high reliability that are fit for clinical applications. Some quantitative methods with higher reliability are present, but clinicians should be aware of the methodological flaws that studies evaluating these methods suffer from. LEVEL OF EVIDENCE Level II, Diagnostic study.
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Affiliation(s)
| | - Maria Papandreou
- Department of Physiotherapy, University of West Attica, Athens, Greece
| | - John Gliatis
- Department of Orthopaedics, University Hospital of Patras, Patras, Greece
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Harrington SE, Hoffman J, Katsavelis D. Measurement of Pectoralis Minor Muscle Length in Women Diagnosed With Breast Cancer: Reliability, Validity, and Clinical Application. Phys Ther 2020; 100:429-437. [PMID: 32043149 DOI: 10.1093/ptj/pzz174] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/23/2019] [Indexed: 11/13/2022]
Abstract
BACKGROUND Decreased pectoralis minor muscle length is common after primary breast cancer treatment and can result in an abnormal position of the scapula. This position can contribute to shoulder pain and pathomechanics and can lead to problems such as impingement syndrome, rotator cuff tears, and frozen shoulder. Currently, there are limited reliable methods for measuring pectoralis minor length. OBJECTIVE The objective of this study was to examine the reliability and validity of measuring pectoralis minor length in women diagnosed with breast cancer. DESIGN This was a cross-sectional reliability and validity study. METHODS Bilateral pectoralis minor length (in centimeters) was assessed using a palpation meter in women (N = 29) diagnosed with breast cancer by 2 licensed physical therapists who were masked to the measures. Bilateral pectoralis minor length was also measured using a motion capture system to assess validity. RESULTS Intratester reliability (intraclass correlation coefficient, ICC [3,k] = 0.971; 95% confidence interval [CI] = 0.939-0.986; standard error of measurement [SEM] = 0.16 cm) and intertester reliability (ICC[3,k] = 0.915; 95% CI = 0.81-0.962; SEM = 0.31 cm) were excellent for the palpation meter on the affected side and the unaffected side (intratester reliability: ICC[3,k] = 0.951; 95% CI = 0.897-0.977; SEM = 0.19 cm; intertester reliability: ICC[3,k] = 0.945; 95% CI = 0.877-0.975; SEM = 0.22 cm). Significant correlations were found between the motion capture system and the palpation meter on the affected side (r = 0.87) and the unaffected side (r = 0.81). Bland-Altman plots between the palpation meter and the motion capture system demonstrated that all the measures fell within the limits of agreement. LIMITATIONS This study encountered possible errors with the accuracy of the motion capture system tracking because of the proximity of the markers and inherent volumetric restrictions. CONCLUSIONS The palpation meter is a reliable, valid, easily administered, and cost-effective tool for assessing pectoralis minor length in women with breast cancer.
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Affiliation(s)
- Shana E Harrington
- Department of Exercise Science, Physical Therapy Program, University of South Carolina, Blatt PE Center, 101G, Columbia, SC 29208 (USA)
| | - Julie Hoffman
- Department of Physical Therapy, Creighton University, Omaha, Nebraska
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Xie Y, Thomas L, Hug F, Johnston V, Coombes BK. Quantifying cervical and axioscapular muscle stiffness using shear wave elastography. J Electromyogr Kinesiol 2019; 48:94-102. [PMID: 31272075 DOI: 10.1016/j.jelekin.2019.06.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 06/10/2019] [Accepted: 06/20/2019] [Indexed: 11/26/2022] Open
Abstract
This study aimed to assess intra-rater (intra-session and inter-day) reliability and influence of side dominance and the scapular resting position on the shear modulus (an index of stiffness) of resting cervical and axioscapular muscles. Sixteen healthy participants were recruited. On day one, ultrasound shear wave elastography was used to measure the shear modulus of superficial and deep cervical extensor and axioscapular muscles bilaterally. Clinical assessments of scapular resting position were performed bilaterally. On day two, testing was repeated on the dominant side. Both intra-session and inter-day reliability were good to excellent for shear modulus of superficial muscles, and poor to excellent for deep muscles. Side differences of shear modulus for posterior upper trapezius were statistically significant but clinically irrelevant. The shear modulus of posterior upper trapezius and middle trapezius were significantly correlated with scapular depression. Ultrasound shear wave elastography is a reliable tool for quantitatively assessing stiffness of superficial cervical and axioscapular muscles. The influence of scapular position should be considered in future comparative studies of healthy controls and patients with neck/shoulder pain. This study provides the necessary first step for future studies on assessing and interpreting the stiffness of cervical and axioscapular muscles for neck and shoulder musculoskeletal disorders.
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Affiliation(s)
- Yanfei Xie
- School of Health and Rehabilitation Science, The University of Queensland, Australia.
| | - Lucy Thomas
- School of Health and Rehabilitation Science, The University of Queensland, Australia
| | - François Hug
- Laboratory "Movement, Interactions, Performance" (EA 4334), UFR STAPS, University of Nantes, France; Institut Universitaire de France (IUF), Paris, France; School of Biomedical Sciences, The University of Queensland, Australia
| | - Venerina Johnston
- School of Health and Rehabilitation Science, The University of Queensland, Australia; RECOVER Injury Research Centre, The University of Queensland, Australia
| | - Brooke K Coombes
- School of Health and Rehabilitation Science, The University of Queensland, Australia; School of Allied Health Sciences, Griffith University, Australia
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Heitz PH, Aubin-Fournier JF, Parent É, Fortin C. Test-retest reliability of posture measurements in adolescents with idiopathic scoliosis. Spine J 2018; 18:2247-2258. [PMID: 29746961 DOI: 10.1016/j.spinee.2018.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 04/16/2018] [Accepted: 05/01/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Posture changes are a major consequence of idiopathic scoliosis (IS). Posture changes can lead to psychosocial and physical impairments in adolescents with IS. Therefore, it is important to assess posture, but the test-retest reliability of posture measurements still remains unknown in this population. PURPOSE The primary objective of the present study was to determine the test-retest reliability of 25 head and trunk posture indices using the Clinical Photographic Postural Assessment Tool (CPPAT) in adolescents with IS. The secondary objective was to determine the standard error of measurement and the minimal detectable change. STUDY DESIGN/SETTING This is a prospective test-retest reliability study carried out at two tertiary university hospital centers. PATIENTS SAMPLE Forty-one adolescents with IS, aged 10-16 years old with curves 10°-45° and treated by medical intervention, were recruited. METHODS Two posture assessments were done using the CPPAT 5-10 days apart following a standardized procedure. Photographs were analyzed with the CPPAT software by digitizing reference landmarks placed on the participant by a physiotherapist evaluator. Generalizability theory was used to obtain a coefficient of dependability, standard error of measurement, and the minimal detectable change at 90% confidence interval. RESULTS Fourteen of 25 posture indices had a good reliability (ϕ≥0.78), 10 had moderate reliability (ϕ=0.55-0.74), and 1 had poor reliability (ϕ=0.45). The most reliable posture indices were waist angle asymmetry (ϕ=0.93), right waist angle (ϕ=0.91), and frontal trunk list (ϕ=0.92). Right sagittal trunk list was the least reliable posture index (ϕ=0.45). The MDC90 values ranged from 2.6 to 10.3° for angular measurements and from 8.4 to 35.1 mm for linear measurements. CONCLUSIONS The present study demonstrates that most posture indices, especially the trunk posture indices, are reproducible in time among adolescents with IS and provides reference values. Clinicians and researchers can use these reference values to assess change in posture over time attributable to treatment effectiveness.
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Affiliation(s)
- Pierre-Henri Heitz
- École de réadaptation, Faculté de médecine, Université de Montréal, 6128, succursale Centre-ville, Montréal, Québec, Canada H3C 3J7
| | - Jean-François Aubin-Fournier
- Centre de réadaptation Marie-Enfant du CHU Sainte-Justine, 5200, rue Bélanger Est, Montréal, Québec, Canada H1T 1C9
| | - Éric Parent
- Department of Physical Therapy, University of Alberta, 8205 114St, Edmonton, Alberta, Canada T6G 2G4
| | - Carole Fortin
- École de réadaptation, Faculté de médecine, Université de Montréal, 6128, succursale Centre-ville, Montréal, Québec, Canada H3C 3J7; Centre de réadaptation Marie-Enfant du CHU Sainte-Justine, 5200, rue Bélanger Est, Montréal, Québec, Canada H1T 1C9; Centre de recherche du CHU Sainte-Justine, 3175, chemin de la Côte-Sainte-Catherine, Montréal, Québec, Canada H3T 1C5.
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Watson L, Balster S, Lenssen R, Hoy G, Pizzari T. The effects of a conservative rehabilitation program for multidirectional instability of the shoulder. J Shoulder Elbow Surg 2018; 27:104-111. [PMID: 28947382 DOI: 10.1016/j.jse.2017.07.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 07/13/2017] [Accepted: 07/14/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND Conservative management is commonly recommended as the first-line treatment for multidirectional instability (MDI) of the shoulder. Despite this, the evidence for efficacy of treatment is limited, and until recently, guidance for clinicians on conservative rehabilitation programs has been inadequate. This study evaluated the effectiveness of a physiotherapy-led exercise program for participants with MDI. METHODS In a single-group study design, 43 participants (16 male, 27 female; mean age, 19.8 years, standard deviation, 4.9 years) diagnosed with MDI undertook a 12-week exercise program. Primary outcome measures were the Melbourne Instability Shoulder Score, Western Ontario Shoulder Instability Index, and Oxford Shoulder Instability Score. Secondary outcomes were strength and scapular position. All measures were taken at baseline and repeated at the conclusion of the program. Test differences before and after rehabilitation were evaluated with dependent t tests and single-group effect size calculations (standardized mean difference [SMD]) to provide a measure of the magnitude of the difference. RESULTS Large effects were found between pre- and postrehabilitation scores on all functional instability questionnaires, with the Western Ontario Shoulder Instability Index demonstrating the largest effect (SMD, -3.04). Scapular upward rotation improved significantly in the early ranges of abduction (0°-60°), with moderate to large effects (SMDs, 0.54-0.95). All strength measures significantly improved, with large differences identified (SMDs, 0.69-2.08). CONCLUSION The identified improvement in functional status, shoulder muscle strength, and scapular positioning after rehabilitation allows greater confidence in the value of conservative management of MDI and informs further research by way of clinical trials in the area.
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Affiliation(s)
- Lyn Watson
- LifeCare Prahran Sports Medicine Centre, Prahran, VIC, Australia; La Trobe Sport and Exercise Medicine Centre, La Trobe University, VIC, Australia; Melbourne Orthopaedic Group, Windsor, VIC, Australia
| | - Simon Balster
- LifeCare Prahran Sports Medicine Centre, Prahran, VIC, Australia; Melbourne Orthopaedic Group, Windsor, VIC, Australia
| | - Ross Lenssen
- LifeCare Prahran Sports Medicine Centre, Prahran, VIC, Australia; La Trobe Sport and Exercise Medicine Centre, La Trobe University, VIC, Australia; Melbourne Orthopaedic Group, Windsor, VIC, Australia
| | - Greg Hoy
- Melbourne Orthopaedic Group, Windsor, VIC, Australia
| | - Tania Pizzari
- La Trobe Sport and Exercise Medicine Centre, La Trobe University, VIC, Australia.
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Wu YT, Choe YW, Peng C, Kim MK. The Immediate Effects of Posterior Pelvic Tilt with Taping on Pelvic Inclination, Gait Function and Balance in Chronic Stroke Patients*. ACTA ACUST UNITED AC 2017. [DOI: 10.13066/kspm.2017.12.3.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Yang-Ting Wu
- Dept. of Rehabilitation Sciences, Graduate School, Daegu University
| | - Yu-Won Choe
- Dept. of Rehabilitation Sciences, Graduate School, Daegu University
| | - Cheng Peng
- Dept. of Rehabilitation Sciences, Graduate School, Daegu University
| | - Myoung-Kwon Kim
- Dept. of Therapy, College of Rehabilitation Sciences, Daegu University
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Reliability of Performance-Based Clinical Measurements to Assess Shoulder Girdle Kinematics and Positioning: Systematic Review. Phys Ther 2017; 97:124-144. [PMID: 27587801 DOI: 10.2522/ptj.20160088] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 08/21/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Deviant shoulder girdle movement is suggested as an eminent factor in the etiology of shoulder pain. Reliable measurements of shoulder girdle kinematics are a prerequisite for optimizing clinical management strategies. PURPOSE The purpose of this study was to evaluate the reliability, measurement error, and internal consistency of measurements with performance-based clinical tests for shoulder girdle kinematics and positioning in patients with shoulder pain. DATA SOURCES The MEDLINE, Embase, CINAHL, and SPORTDiscus databases were systematically searched from inception to August 2015. STUDY SELECTION Articles published in Dutch, English, or German were included if they involved the evaluation of at least one of the measurement properties of interest. DATA EXTRACTION Two reviewers independently evaluated the methodological quality per studied measurement property with the 4-point-rating scale of the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) checklist, extracted data, and assessed the adequacy of the measurement properties. DATA SYNTHESIS Forty studies comprising more than 30 clinical tests were included. Actual reported measurements of the tests were categorized into: (1) positional measurement methods, (2) measurement methods to determine dynamic characteristics, and (3) tests to diagnose impairments of shoulder girdle function. Best evidence synthesis of the tests was performed per measurement for each measurement property. LIMITATIONS All studies had significant limitations, including incongruence between test description and actual reported measurements and a lack of reporting on minimal important change. In general, the methodological quality of the selected studies was fair to poor. CONCLUSIONS High-quality evidence indicates that measurements obtained with the Modified Scapular Assistance Test are not reliable for clinical use. Sound recommendations for the use of other tests could not be made due to inadequate evidence. Across studies, diversity in description, performance, and interpretation of similar tests was present, and different criteria were used to establish similar diagnoses, mostly without taking into account a clinically meaningful context. Consequently, these tests lack face validity, which hampers their clinical use. Further research on validity and how to integrate a clinically meaningful context of movement into clinical tests is warranted.
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Shadmehr A, Sarafraz H, Heidari Blooki M, Jalaie S, Morais N. Reliability, agreement, and diagnostic accuracy of the Modified Lateral Scapular Slide test. ACTA ACUST UNITED AC 2016; 24:18-24. [DOI: 10.1016/j.math.2016.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 04/10/2016] [Accepted: 04/12/2016] [Indexed: 12/23/2022]
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Reliability and Validity of the Measurement of Scapular Position Using the Protractor Method. Phys Ther 2016; 96:502-10. [PMID: 26337260 DOI: 10.2522/ptj.20150144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 08/28/2015] [Indexed: 01/12/2023]
Abstract
BACKGROUND The protractor method is a proposed clinical assessment tool, the first to measure vertical scapular position, that directly compares scapular and spinal landmarks. This tool has the potential to reliably and accurately measure excessive scapular elevation or depression. OBJECTIVE The purpose of this study was to determine reliability and validity of the protractor method to measure resting scapular position. DESIGN An interrater and intratester reliability and validity study was conducted. METHODS Testing was conducted on the same day by 2 physical therapists who were blinded to each other's results. The vertical distances between the spinous process of C7 and the superior margin of the medial aspect of the spine of the scapula (C7 method) and the spinous process of T8 and the inferior angle of the scapula (T8 method) were palpated and measured on the symptomatic shoulder in 34 people with current shoulder pain using the protractor method. Measurements were compared with 2-dimensional camera analysis to assess validity. RESULTS For intertester reliability, the standard error of measure, minimal detectable change, and intraclass correlation coefficient were 6.3 mm, 17.3 mm, and .78, respectively, for the C7 method and 5.7 mm, 15.7 mm, and .82, respectively, for the T8 method. For intratester reliability, the standard error of measure, minimal detectable change, and intraclass correlation coefficient were <0.9 mm, <2.5 mm, and .99, respectively. For validity, significant correlations (r) and mean differences were .83 and 10.1 mm, respectively, for the C7 method and .92 and 2.2 mm, respectively, for the T8 method. LIMITATION The results of this study are limited to static measurement of the scapula in one plane. CONCLUSION Both protractor methods were shown to have good reliability and acceptable validity, with the T8 method demonstrating superior clinical utility. The clinical use of the T8 method is recommended for measurement of excessive resting scapular elevation or depression.
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Shadmehr A, Azarsa MH, Jalaie S. Inter- and intrarater reliability of modified lateral scapular slide test in healthy athletic men. BIOMED RESEARCH INTERNATIONAL 2014; 2014:384149. [PMID: 24900963 PMCID: PMC4036411 DOI: 10.1155/2014/384149] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 04/14/2014] [Accepted: 04/22/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The reliability of lateral scapular slide test (LSST) at 90 degrees of abduction is controversial; therefore, in order to achieve more reliability it may be necessary to make changes in this particular position. METHODS Modified lateral scapular slide test (MLSST) was done on thirty male basketball players with two examiners in one session and for the retest with one examiner in the next week. The test was done in 7 positions: arm relaxed at the side (P1), 90 degrees of abduction (P2), 90 degrees of scaption without having a weight in hands (P3), 90 degrees of scaption with having 3 different weights (1, 2, and 4 kg) in hands (P4, P5, and P6, resp.), and 180 degrees of scaption without having a weight in hands (P7). RESULTS In P1 and P6, the ICC scores indicated the highest level of intrarater reliability. In P2, the ICC scores showed a fair level of intrarater reliability, as the minimum reliability. The maximum and minimum interrater reliability were P1 and P4, respectively. CONCLUSION Scaption with loading, as a functional position in the overhead athletes, is a reliable positioning and may be replaced with the third position of the traditional LSST.
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Affiliation(s)
| | | | - Shohreh Jalaie
- Enghelab Avenue, Pitch-e-shemiran, Tehran 11489-65141, Iran
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Lee JH, Yoo WG, Kim MH, Oh JS, Lee KS, Han JT. Effect of posterior pelvic tilt taping in women with sacroiliac joint pain during active straight leg raising who habitually wore high-heeled shoes: a preliminary study. J Manipulative Physiol Ther 2014; 37:260-8. [PMID: 24780371 DOI: 10.1016/j.jmpt.2014.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 11/24/2013] [Accepted: 01/14/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The purpose of this study was to assess whether a 1-day application of posterior pelvic tilt taping (PPTT) using a kinesiology tape would decrease anterior pelvic tilt and active straight leg raising test scores in women with sacroiliac joint who habitually wore high-heeled shoes. METHODS Sixteen women (mean age, 23.63 ± 3.18 years) were enrolled in this study. Anterior pelvic tilt was measured using a palpation meter before PPTT application, immediately after PPTT application, 1 day after PPTT application, and immediately after PPTT removal after 1 day of application. Active straight leg raising scores were measured at the same periods. Posterior pelvic tilt taping was applied in the target position (posterior pelvic tilt position). RESULTS The anterior pelvic tilt was decreased during and after 1 day of PPTT application (before and after kinesiology tape removal) compared with the initial angle (all P < .05). Active straight leg raising scores were decreased during and 1 day after PPTT application (before and after kinesiology tape removal) compared with the initial score (all P < .05). CONCLUSION The results of this preliminary study suggests that PPTT may temporarily decrease anterior pelvic tilt and active straight leg raising score in women with sacroiliac joint pain who habitually wear high-heeled shoes.
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Affiliation(s)
- Jung-Hoon Lee
- Professor, Department of Physical Therapy, College of Nursing and Healthcare Sciences, Dong-Eui University, Republic of Korea
| | - Won-Gyu Yoo
- Professor, Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Gimhae, Republic of Korea.
| | - Mi-Hyun Kim
- Professor, Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Gimhae, Republic of Korea
| | - Jae-Seop Oh
- Professor, Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Gimhae, Republic of Korea
| | - Kyung-Soon Lee
- Professor, Department of Physical Therapy, Dong Ju College University, Busan, Republic of Korea
| | - Jin-Tae Han
- Professor, Department of Physical Therapy, Kyung-sung University, Busan, Republic of Korea
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Larsen CM, Juul-Kristensen B, Lund H, Søgaard K. Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review. Physiother Theory Pract 2014; 30:453-82. [PMID: 24678755 DOI: 10.3109/09593985.2014.899414] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The aims were to compile a schematic overview of clinical scapular assessment methods and critically appraise the methodological quality of the involved studies. A systematic, computer-assisted literature search using Medline, CINAHL, SportDiscus and EMBASE was performed from inception to October 2013. Reference lists in articles were also screened for publications. From 50 articles, 54 method names were identified and categorized into three groups: (1) Static positioning assessment (n = 19); (2) Semi-dynamic (n = 13); and (3) Dynamic functional assessment (n = 22). Fifteen studies were excluded for evaluation due to no/few clinimetric results, leaving 35 studies for evaluation. Graded according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN checklist), the methodological quality in the reliability and validity domains was "fair" (57%) to "poor" (43%), with only one study rated as "good". The reliability domain was most often investigated. Few of the assessment methods in the included studies that had "fair" or "good" measurement property ratings demonstrated acceptable results for both reliability and validity. We found a substantially larger number of clinical scapular assessment methods than previously reported. Using the COSMIN checklist the methodological quality of the included measurement properties in the reliability and validity domains were in general "fair" to "poor". None were examined for all three domains: (1) reliability; (2) validity; and (3) responsiveness. Observational evaluation systems and assessment of scapular upward rotation seem suitably evidence-based for clinical use. Future studies should test and improve the clinimetric properties, and especially diagnostic accuracy and responsiveness, to increase utility for clinical practice.
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Affiliation(s)
- Camilla Marie Larsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark , Odense , Denmark
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17
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Yoo WG. Comparison of Isolation Ratios of the Scapular Retraction Muscles between Protracted Scapular and Asymptomatic Groups. J Phys Ther Sci 2013; 25:905-6. [PMID: 24259881 PMCID: PMC3820207 DOI: 10.1589/jpts.25.905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 03/20/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to compare the isolation ratios of scapular retraction muscles between protracted scapular and asymptomatic groups. [Subjects] Seven males with protracted scapular and seven asymptomatic males aged 20-30 years were recruited. [Methods] We measeured the rhomboid, middle trapezius (MT), and lower trapezius (LT) muscles activities, and calculated the isolation ratio. [Results] The rhomboid and MT isolation ratio of the protracted scapular group was not significantly different from that of the asymptomatic group. The LT isolation ratio of the protracted scapular group was significantly lower than that of the asymptomatic group. [Conclusion] We suggest that a proper retraction exercise, for patients with protracted scapular posture is one that includes exercises for selectively strengthening the lower trapezius muscle.
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Affiliation(s)
- Won-Gyu Yoo
- Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University and Elderly Life Redesign Institute
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18
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Roy JS, Esculier JF. Psychometric evidence for clinical outcome measures assessing shoulder disorders. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/1743288x11y.0000000043] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Park S, Yoo W. Effect of Sustained Typing Work on Changes in Scapular Position, Pressure Pain Sensitivity and Upper Trapezius Activity. J Occup Health 2013; 55:167-72. [DOI: 10.1539/joh.12-0254-oa] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Se‐Yeon Park
- Department of Physical TherapyThe Graduate School, Inje UniversityRepublic of Korea
| | - Won‐Gyu Yoo
- Department of Physical TherapyCollege of Biomedical Science and Engineering, Inje UniversityRepublic of Korea
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McKenna L, Straker L, Smith A. Can scapular and humeral head position predict shoulder pain in adolescent swimmers and non-swimmers? J Sports Sci 2012; 30:1767-76. [DOI: 10.1080/02640414.2012.718092] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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22
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Intertester reliability of a classification system for shoulder pain. Physiotherapy 2012; 98:40-6. [DOI: 10.1016/j.physio.2010.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Accepted: 12/16/2010] [Indexed: 11/22/2022]
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Rondeau MW, Padua DA, Thigpen CA, Harrington SE. Precision and Validity of a Clinical Method for Pectoral Minor Length Assessment in Overhead-Throwing Athletes. ACTA ACUST UNITED AC 2012. [DOI: 10.3928/19425864-20110630-01] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Lee JH, Yoo WG. Application of posterior pelvic tilt taping for the treatment of chronic low back pain with sacroiliac joint dysfunction and increased sacral horizontal angle. Phys Ther Sport 2011; 13:279-85. [PMID: 23068906 DOI: 10.1016/j.ptsp.2011.10.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 05/17/2011] [Accepted: 10/23/2011] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Kinesio Taping (KT) is a therapeutic method used by physical therapists and athletic trainers in combination with other treatment techniques for various musculoskeletal and neuromuscular problems. However, no research has evaluated the effect of KT in patients with low back pain (LBP). The purpose of this case was to describe the application of posterior pelvic tilt taping (PPTT) with Kinesio tape as a treatment for chronic LBP and to reduce the anterior pelvic tilt angle. DESIGN Case report. CASE DESCRIPTION The patien was a 20-year-old female amateur swimmer with a Cobb's angle (L1-S1) of 68°, a sacral horizontal angle of 45°, and pain in both medial buttock areas and sacroiliac joints. We performed PPTT with Kinesio tape for 2 weeks (six times per week for an average of 9 h each time). RESULTS The patient’s radiographs showed that the Cobb's angle (L1-S1) had decreased from 68° to 47° and that the sacral horizontal angle had decreased from 45° to 31°. Reductions in hypomobility or motion asymmetry, as assessed by the motion palpation test, and in pain, as measured by the pain-provocation tests, were observed. On palpation for both medial buttock areas in the prone position, the patient felt no pain. The patient experienced no pain or stiffness in the low back area while performing forward flexion in the standing position with knees fully extended when washing dishes in the sink. CONCLUSIONS The case study demonstrated that PPTT intervention favourably affected the pelvic inclination and sacral horizontal angle, leading to beneficial effects on sacroiliac joint dysfunction (SIJD) and medial buttock pain. Additional research on the clinical effects of this taping procedure requires greater numbers of athletes with SIJD or LBP who have inappropriate anterior pelvic tilt angles and hyperlordosis.
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Affiliation(s)
- Jung-hoon Lee
- Department of Physical Therapy, Inje University Pusan Paik Hospital and Department of Physical Therapy, The Graduate School, Inje University, Republic of Korea
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Lee JH, Yoo WG. The mechanical effect of anterior pelvic tilt taping on slump sitting by seated workers. INDUSTRIAL HEALTH 2011; 49:403-409. [PMID: 21697629 DOI: 10.2486/indhealth.ms1230] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The objectives of this study were to determine whether there is a change in the pelvic inclination after about 30 min of slump sitting by seated workers, and if so, to determine whether these changes can be prevented by the application of anterior pelvic tilt taping (APTT). The subjects who consented to participate in the experiment were randomly allocated to two groups: no-APTT group and APTT group. The no-APTT group performed slump sitting for 30 min, and the both pelvic inclinations were remeasured. In the APTT group, the both pelvic inclinations were measured immediately after the application of the APTT, and then again after 30 min of slump sitting. The both pelvic inclinations in the no-APTT group were significantly decreased (p<0.05) after they returned to the upright standing posture. The both pelvic inclinations in the APTT group were significantly increased immediately after the APTT (p<0.05), and this increase was maintained when returning to the upright standing posture after 30 min of slump sitting (p>0.05). We suggest that APTT can be applied as an auxiliary treatment method for preventing changes in pelvic inclination and musculoskeletal problems of low back area by awkward sitting posture in the seated worker.
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Affiliation(s)
- Jung-Hoon Lee
- Department of Physical Therapy, The Graduate School, Inje University, 607 Obang-dong, Gimhae, Gyeongsangnam-do, Republic of Korea
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