Abstract
Interrater Reliability of a Proposed Scapular Classification System
The Journal of orthopaedic and sports physical therapy, v 36(1), pp A10-A10
01 Jan 2006
Abstract
Purpose/Hypothesis: Normal scapular motion is important for proper shoulder function. Abnormal scapular motion has been linked to various shoulder conditions including impingement, instability, and tendonitis. Because of this, assessment of scapular motion is being performed more frequently as part of the examination process; however, there is a lack of consensus as to how scapular motion should be clinically assessed. To address this issue, clinicians have begun to develop scapular classification systems. To date, 3 studies have investigated the interrater reliability of visually based assessments of scapular motion. These studies have used a variety of tests to assess scapulothoracic motion and have yielded moderate reliability. There has been no study to date investigating which tests are most useful for determining abnormal scapular motion. The purpose of this study was to investigate the reliability of a proposed scapular motion classification system and
to identify which tests used in the system are most useful for classifying scapular motion.
Number of Subjects: Forty-seven subjects (30 females, 17 males; average age of 24 years) met the inclusion criteria for the study.
Materials/Methods: In all subjects, both shoulders were assessed for a total of 94 shoulders. Thirteen subjects had shoulder pain in one shoulder at the time of testing. Two digital video recorders, one placed overhead and one placed behind the subject were used to record motion of the upper extremity during a series of 5 different tests. The tests included: (1) active flexion, (2) active flexion with resistance (1.3 kg females, 2.2 kg males), (3) active abduction, (4) active abduction with resistance (1.3 kg females, 2.2 kg males), and (5) resisted shoulder external rotation in neutral.
The videos were viewed by 5 raters (2 experienced PTs, 2 DPT students, and 1 ATC) and scapular motion was determined to be either normal or abnormal by each rater. The Kappa statistic was used to determine the interrater reliability among the 5 raters. Percent agreement was also calculated.
Results: Percent agreement was 80.2% and k was 0.52 among all 5 raters. Weighted flexion yielded the highest frequency of abnormal ratings (48 out of a possible 50 ratings), followed by active flexion (43/50), weighted abduction (34/50), active abduction (29/50), and resisted shoulder external rotation (23/50).
Conclusions: This classification system yielded moderate reliability. Weighted movements (especially weighted flexion) were more useful for revealing scapular abnormality than just active movements. This may be due to increased muscular challenge during the resisted motions. The views obtained from the posterior view were more useful than the superior views.
Clinical Relevance: The classification system is clinically feasible and may allow clinicians to more effectively and efficiently evaluate abnormal scapular motion. Determining in which plane (sagittal or frontal) the scapular abnormality exists may also allow the clinician to correctly identify and address impairments of specific scapular stabilizers
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Details
- Title
- Interrater Reliability of a Proposed Scapular Classification System
- Creators
- Kevin E Gard - Drexel University, Physical Therapy (and Rehabilitation Sciences)J Finocchiaro - Drexel UniversityDuane David Ebaugh - Drexel University
- Publication Details
- The Journal of orthopaedic and sports physical therapy, v 36(1), pp A10-A10
- Conference
- American Physical Therapy Association (APTA) Combined Sections Meeting (CSM 2006) (San Diego, California, United States, 02 Feb 2006–05 Feb 2006)
- Number of pages
- 1
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Physical Therapy (and Rehabilitation Sciences)
- Other Identifier
- 991020650713804721