Measurement Errors of a Test to Determine the Scapular Position Using a Tape Measure

Reliability of Performance-Based Clinical Measurements to Assess Shoulder Girdle Kinematics and Positioning: Systematic Review

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.

Reproducibility and validity of the 50-meter walking test in community-dwelling elderly

[Purpose] This study aimed to investigate the reproducibility and validity of the 50-m walking test. [Subjects] Reproducibility was investigated in 19 community-dwelling elderly women (mean age, 76.3 years), and validity was investigated in 31 community-dwelling elderly individuals (12 men and 19 women; mean age, 75.7 years). [Methods] The time taken to walk 50 m, the time taken to walk each 10-m section (laps 1-5), the time taken to walk 10 m, and grip strength were measured. In addition, the functional reach test (FRT), one-leg standing test, and timed up and go (TUG) test were performed. [Results] In a reproducibility analysis, the interclass correlation coefficient (1,1) was 0.97. In a Bland-Altman analysis, no systematic error was found. The measured values from the 50-m walking test included a measurement error of 1.5 s, and the acceptable margin of error was confirmed to be 3.1 s. In a validity analysis, the 50-m walking test score was significantly correlated with the 10-m walking and TUG test scores. [Conclusion] Our results suggest that the 50-m walking test score may be a useful index of the walking ability of community-dwelling elderly.

Test-retest reliability of expiratory abdominal compression with a handheld dynamometer in patients with prolonged mechanical ventilation

[Purpose] The present study aimed to examine the test-retest reliability of expiratory abdominal compression with a handheld dynamometer in patients with prolonged mechanical ventilation. [Subjects and Methods] We recruited 18 patients with prolonged mechanical ventilation. All patients had impaired consciousness. The mode of the ventilator was synchronized intermittent mandatory ventilation. The abdomen above the navel was vertically compressed using a handheld dynamometer in synchronization with expiration. Expiratory abdominal compression was performed two times. We measured the tidal volume during expiratory abdominal compression. There was an interval of 5 minutes between the first and second measurements. Intraclass correlation coefficient (ICC) and Bland-Altman analysis were performed to examine the test-retest reliability of expiratory abdominal compression with a handheld dynamometer. [Results] The test-retest reliability of expiratory abdominal compression was excellent (ICC(1, 1): 0.987). Bland-Altman analysis showed that there was no fixed bias and no proportional bias. [Conclusion] The findings of this study suggest that expiratory abdominal compression with a handheld dynamometer is reliable and useful for patients with respiratory failure and prolonged mechanical ventilation.

Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review

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.