Reliability of Thoracic Spine Rotation Range-of-Motion Measurements in Healthy Adults

Abstract

Context:The reliability of clinical techniques to quantify thoracic spine rotation range of motion (ROM) has not been evaluated.Objective: To determine the intratester and intertester reliability of 5 thoracic rotation measurement techniques.Design: Descriptive laboratory study. Setting: University research laboratory.Patients or Other Participants: Forty-six healthy volunteers (age=23.6±4.3 years, height=171.0±9.6 cm, mass= 71.4 ± 16.7 kg).Main Outcome Measure(s): We tested 5 thoracic rotation ROM techniques over 2 days: seated rotation (bar in back and front), half-kneeling rotation (bar in back and front), and lumbar-locked rotation. On day 1, 2 examiners obtained 2 sets of measurements (sessions 1, 2) to determine the within-session intertester reliability and within-day intratester reliability. A single examiner obtained measurements on day 2 (session 3) to determine the intratester reliability between days. Each technique was performed 3 times per side, and averages were used for data analysis. Reliability was determined using intraclass correlation coefficients, standard error of measurement (SEM), and minimal detectable change (MDC). Differences between raters during session 1 were determined using paired t tests.Results: Within-session intertester reliability estimates ranged from 0.85 to 0.94. Ranges for the SEM were 1.0°to 2.3°a nd for the MDC were 2.8°to 6.3°. No differences were seen between examiners during session 1 for seated rotation (bar in front, both sides), half-kneeling rotation (bar in front, left side), or the lumbar locked position (both sides) (all values of P> .05). Within-day intratester reliability estimates ranged from 0.86 to 0.95. Ranges for the SEM were 0.8°to 2.1°and for the MDC were 2.1°to 5.9°. Between-days intratester reliability estimates ranged from 0.84 to 0.91. Ranges for the SEM were 1.4°to 2.0°a nd for the MDC were 3.9°to 5.6°.Conclusions: All techniques had good reliability and low levels of measurement error. The seated rotation, bar in front, and lumbar-locked rotation tests may be used reliably when more than 1 examiner is obtaining measurements.Key Words: biomechanics, bubble inclinometer, goniometer, scapulothoracic joint Key Points• Within-session and between-sessions reliability values for the 2 examiners for each of the 5 thoracic rotation range-ofmotion measurement techniques were good. • All measurement techniques showed low SEM « 3°) and minimal detectable change « 6°) values for all techniques.• The seated rotation, bar in front, and lumbar-locked rotation tests did not display differences between examiners during session 1. These techniques may be used with confidence by clinicians and researchers.

Clinical methods to quantify trunk mobility in an elite male surfing population

“…It most importantly presented the range of thoracic rotation in an elite surfing cohort which was significantly greater than the comparative group (see Table 3). When comparing the comparative group mean rotation values to previous research by Johnson et al (2012) using the identical inclinometer method the results are very similar (40.80° vs. 44.76°; average age 31 vs. 24 years respectively). It also needs to be pointed out that the elite surfing cohort mean (63.57°) appears significantly greater to the results of Johnson et al (2012).…”

“…The method chosen to measure thoracic rotation is known as the lumbar locked position (Johnson, Kim, Yu, Saliba, & Grindstaff, 2012). Here the participant is required to assume a four point kneeling position with both knees and hips in maximal flexion.…”

The Role of Rotational Mobility and Power on Throwing Velocity

“…The femur was stabilized to limit accessory motion, whereas the lower shank was rotated (internally and externally) until end ROM (11). Seated thoracic ROM assessment ( Figures 5A, B) was performed on a box (30 inches/76.2 cm high) with the hips and knees flexed at 908, and a ball (20 cm diameter) was placed between the knees to minimize motion of the lower extremities during thoracic rotation (9).…”

“…In this regard, a seated bar in a front rotational test with high reliability (intraclass correlation coefficient [ICC] . 0.80) can be used to provide evidence of thoracic mobility with a goniometer (9). Similarly, a seated hip rotational assessment has also been incorporated successfully (11) and considered highly reliable (ICCs: 0.93 and 0.96; Coefficient of Variation (CV): 12.3 and 8.3%) using an inclinometer (16).…”

A biomechanical evaluation of the combined elevation test

“…The CET is thought to identify impairments in range of motion during synchronised thoracic extension, glenohumeral joint (GHJ) flexion, and retraction and upward rotation of the scapula (Dennis et al, 2008a;Harvey, 1998). Whilst there are screening tests to assess shoulder flexion (Wilk et al, 2015), scapula upward rotation and retraction (Forthomme, Crielaard, & Croisier, 2008), and thoracic rotation (Johnson, Kyung-Min, Byung-Kyu, Salibar, & Grindstaff, 2012), extension of the thoracic spine does not feature in any other field-based assessment tool, thus demonstrating the value of the CET.…”