Measurement of scapula upward rotation: a reliable clinical procedure

Abstract

Background: It is important to deal with the scapula when developing rehabilitation strategies for the shoulder complex. This requires clinical measurement tools that are readily available and easy to apply and which provide a reliable evaluation of scapula motion. Aim: To determine the reliability of the Plurimeter-V gravity inclinometer for the measurement of scapular upward rotation positions during humeral elevation in coronal abduction in a group of patients with shoulder pathology. Method: Twenty six patients were assessed in two repeat tests within a single testing session. Patients exhibiting a wide spectrum of shoulder pathology were selected. The angle of scapular upward rotation was measured during total shoulder abduction. The measurement protocol was performed twice during a single testing session by a single tester. Results of the two tests were compared and the reliability assessed by intraclass correlation coefficients (ICCs). Results: There was no significant difference in the scapula measurements taken during the two tests at each testing position. Overall, there was very good intrarater reliability (ICC = 0.88). The ICC ranged from 0.81 (at 135˚) to 0.94 (at both resting and end of total shoulder abduction range). Conclusion: The Plurimeter-V gravity inclinometer can be used effectively and reliably for measuring upward rotation of the scapula in all ranges of shoulder abduction in the coronal plane.

Clinical Measurement of Scapular Upward Rotation in Response to Acute Subacromial Pain

“…8,11,28,35 Upward/downward rotation of the scapula was measured relative to horizontal by aligning the indented Y of each palpation dowel along the medial and lateral aspect of the scapular spine (FIGURE 1). 8,11,37 Prior research has indicated that measurement of scapular upward/ downward rotation with a modified digital inclinometer is a reliable procedure. 8,11 A priori reliability testing of 15 healthy participants, tested twice over a 48-hour period, was performed by the principal investigator.…”

Scapulohumeral control after stroke: A preliminary study of the test-retest reliability and discriminative validity of a clinical scapular protocol (ClinScaP)

“…In this way, it enables therapists to clinically identify scapular characteristics or dysfunctions, which could be related to various levels of PAF. The included tests in the ClinScaP were chosen based on their acceptable psychometric properties in musculoskeletal rehabilitation and on our assumption that these tests were related to a specific scapular rotation (DiVeta et al, 1990;Gibson, Goebel, Jordan, Kegerreis, & Worrell, 1995;Lluch et al, 2014;Nijs et al, 2005;Struyf, Meeus, et al, 2014;Struyf et al, 2009;Watson et al, 2005). We furthermore opted to add static as well as dynamic tests, deemed feasible for IwS, even with a low PAF.…”

“…The inclinometer was held manually on the scapular spine by the skilled physiotherapist, while an assisting physiotherapist passively elevated the participant's arm in the sagittal plane (forward flexion) with the elbow extended and the thumb pointing upward. The amount of lateral rotation (degrees) was read from the inclinometer at rest (arm alongside the body), and at 45 • , 90 • and 135 • of passive forward flexion (determined by goniometry) (Watson et al, 2005).…”

“…As such, clinical observation of tilting and winging in rest and during movement is chosen to assess threedimensional scapular protraction and tilting (Kibler & Sciascia, 2010;Nijs, Roussel, Vermeulen, & Souvereyns, 2005;Struyf et al, 2009;Struyf et al, 2011;Struyf et al, 2013); these scapular rotations are further assessed with the scapular distance test, the pectoralis minor index and the acromial index (Borstad & Ludewig, 2005;DiVeta, Walker, & Skibinski, 1990;Nijs et al, 2005;Struyf, Meeus, et al, 2014). Scapular lateral rotation is assessed based on inclinometry at different forward flexion heights (Watson, Balster, Finch, & Dalziel, 2005). Dynamic scapulohumeral control is assessed based on maximal active humeral elevation and the medial rotation test (Lluch et al, 2014;Morrissey, Morrissey, Driver, King, & Woledge, 2008).…”

Refining scapulothoracic kinematic measurement and characterising scapulothoracic resting posture in those with and without chronic non-specific neck pain

“…Measurement of the scapular upward rotation has been performed using a variety of measuring tools including the 'modified inclinometer' (Johnson et al, 2001), 'Plurimeter-V gravity inclinometer' (Watson et al, 2005), and the 'scapulohumeral goniometer' (Youdas et al, 1994). Only the first two of these tools have demonstrated good inter-rater reliability.…”