Evaluation of Apparent and Absolute Supraspinatus Strength in Patients with Shoulder Injury Using the Scapular Retraction Test

Kibler, W. Ben; Sciascia, Aaron; Dome, David

doi:10.1177/0363546506288728

Cited by 212 publications

(138 citation statements)

References 20 publications

(24 reference statements)

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“…Kibler et al 21 have reported on the effect of a similar repositioning maneuver, the Scapula Retraction Test, using what is described as a "proprioceptive reminder" via minimal forearm pressure on the scapula during the same isometric resisted elevation task used in this study. They reported a 24% mean increase in strength between the empty can in the natural posture and repositioned test in symptomatic subjects, with all 20 symptomatic subjects demonstrating strength gains with repositioning.…”

Section: Discussionmentioning

confidence: 87%

“…First, our subjects with impingement represented a subclinical, college-age population, some of whom were asymptomatic except with provocation testing, while others had only mild symptoms. The subjects in the Kibler et al 21 study were older with a wide age range (mean  SD, 43  16 years) and had diagnoses of labral injury, glenohumeral instability, or impingement with medical imaging (MRI) evidence of pathology, and were described as having decreased supraspinatus strength and scapular dyskinesis on clinical exam. Of the 142 subjects in our study, less than one third demonstrated scapular dyskinesis, as determined by a visual classification system.…”

Section: Discussionmentioning

confidence: 99%

“…The "empty can" position has been shown to preferentially activate the supraspinatus muscle 48 and has been used in a study similar to ours. 21 …”

Section: Methodsmentioning

confidence: 99%

“…Rabin stabilization of the scapula in a position of retraction in relation to the thorax by manual application of force along the medial border of the scapula. 21 Kibler and colleagues 21 measured pain and elevation strength during isometric shoulder elevation in the scapular plane with the scapula in its natural position and when manually retracted in a group of 20 patients with shoulder pathology and 10 asymptomatic controls. They reported an increase in shoulder elevation strength when tested with the scapula manually maintained in a retracted position compared to when tested with the scapula in its natural "rest" position in all of their patients.…”

mentioning

confidence: 99%

“…Therefore, we modified the test position described by Kibler et al 21 by emphasizing posterior tilting and external rotation of the scapula but avoiding full retraction and named it the Scapula Reposition Test (SRT).…”

mentioning

confidence: 99%

See 4 more Smart Citations

Effect of the Scapula Reposition Test on Shoulder Impingement Symptoms and Elevation Strength in Overhead Athletes

Tate¹,

McClure²,

Kareha³

et al. 2008

J Orthop Sports Phys Ther

148

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[ research report ] t Study deSign: Two-group, repeatedmeasures design.t ObjectiveS: To determine whether manually repositioning the scapula using the Scapula Reposition Test (SRT) reduces pain and increases shoulder elevation strength in athletes with and without positive signs of shoulder impingement.t backgrOund: Symptom alteration tests may be useful in determining a subset of those with shoulder pathology who may benefit from interventions aimed at improving scapular motion abnormalities.t MethOdS and MeaSureS: One hundred forty-two college athletes underwent testing for clinical signs of shoulder impingement. Tests provoking symptoms were repeated with the scapula manually repositioned into greater retraction and posterior tilt. A numeric rating scale was used to measure symptom intensity under both conditions. Isometric shoulder elevation strength was measured using a mounted dynamometer with the scapula in its natural position and with manual repositioning. A paired t test was used to compare the strength between positions. The frequency of a significant increase in strength with scapular repositioning, defined as the minimal detectable change (90% confidence interval), was also assessed.t reSultS: Of the 98 athletes with a positive impingement test, 46 had reduced pain with scapular repositioning. Although repositioning produced an increase in strength in both the impingement (P = .001) and nonimpingement groups (P = .012), a significant increase in strength was found with repositioning in only 26% of athletes with, and 29% of athletes without, positive signs for shoulder impingement. 27,51 In addition to the variability of findings in these studies, the magnitude of differences between those with healthy shoulders and those with pathology is typically small (in the 3° to 5° range), and it is unclear whether these differences, although statistically significant, are really of clinical significance. Because of the variability of findings in symptomatic subjects and the generally small kinematic differences found compared to asymptomatic subjects, correctly identifying patients with relevant scapular dysfunction is difficult.An alternative approach in attempting to identify those with scapular motion abnormalities is the use of symptom altering tests. The premise of these tests is to assess the magnitude of symptoms during provocation tests or shoulder movements when the scapula is in its natural position and then to repeat the provocative tests and shoulder movements with the examiner manually altering scapular motion or position. Two symptom alteration tests have been reported in the literature. The Modified Scapular Assistance test involves application of both an upward rotary and retraction force to the scapula by a single examiner in an effort to reduce pain during arm elevation. Rabin et al 40 reported satisfactory interrater reliability of this test for clinical use. The Scapula Retraction Test has been described as 1 Physical Therapist, H/S Therapy Associates, Inc, Lower Gwynedd, PA; Associate Fac...

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

“…The "empty can" position has been shown to preferentially activate the supraspinatus muscle 48 and has been used in a study similar to ours. 21 …”

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%