Scientific/Clinical Article| Volume 30, ISSUE 2, P221-231, April 2017

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Shoulder proprioception: How is it measured and is it reliable? A systematic review

  • Amanda L. Ager
    Corresponding author. Laval University and Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec, CIRRIS-IRDPQ, 525, boulevard Wilfrid-Hamel, Quebec, Quebec G1M 2S8, Canada. Tel. +1-418-529-9141; fax: +1-418-529-3548.
    Center for Interdisciplinary Research in Rehabilitation and Social Integration, Rehabilitation Institute, Quebec, Canada

    Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada
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  • Jean-Sébastien Roy
    Center for Interdisciplinary Research in Rehabilitation and Social Integration, Rehabilitation Institute, Quebec, Canada

    Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada
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  • Marianne Roos
    Center for Interdisciplinary Research in Rehabilitation and Social Integration, Rehabilitation Institute, Quebec, Canada

    Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada
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  • Amélie Fournier Belley
    Center for Interdisciplinary Research in Rehabilitation and Social Integration, Rehabilitation Institute, Quebec, Canada

    Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada
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  • Ann Cools
    Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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  • Luc J. Hébert
    Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada

    Department of Radiology and Nuclear Medicine, Faculty of Medicine, Laval University, Quebec, Canada
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      Study Design

      Systematic review.


      Constituents of proprioception include our awareness of the position (joint position sense [JPS]) and motion (kinesthesia) of our limbs in space. Proprioceptive deficits are associated with musculoskeletal disorders but remain a challenge to quantify, particularly at the shoulder.

      Purpose of the Study

      To report the psychometric values of validity, reliability, and responsiveness for shoulder JPS and/or kinesthesia protocols.


      A review of 5 databases was conducted from inception to July 2016 for studies reporting a psychometric property of a shoulder proprioception protocol. The included studies were evaluated using the QualSyst checklist and COSMIN 4-point scale.


      Twenty-one studies were included, yielding 407 participants and 553 evaluated shoulders (n). The included studies support excellent methodological scores using the QualSyst checklist (88.1 ± 9.9%) and good psychometric scores with the COSMIN for reliability (71.1%) and moderate-to-low quality score (50%) for criterion validity. Weighted average intraclass correlation coefficients (ICCs) for intrarater reliability were highest for passive JPS and kinesthesia, ICC = 0.92 ± 0.07 (n = 214) and ICC = 0.92 ± 0.04 (n = 74), respectively. The most reliable movement and tool are internal rotation at 90° of abduction, ICC = 0.88 ± 0.01 (n = 53), and the dynamometer, ICC = 0.92 ± 0.88 (n = 225). Only 2 studies quantify an aspect of validity and no responsiveness indices were reported among the included studies.


      Based on the results of the included studies, the evaluation of shoulder proprioception is most reliable when using a passive protocol with an isokinetic dynamometer for internal rotation at 90° of shoulder abduction. Standardized protocols addressing the psychometric properties of shoulder proprioception measures are needed.

      Level of Evidence

      Level 1a: systematic review.


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      JHT Read for Credit

      Quiz: #483

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to There is only one best answer for each question.
      • #1.
        The article design is
        • a.
        • b.
        • c.
          a case series
        • d.
          a systematic review
      • #2.
        To evaluate proprioception it is key to evaluate
        • a.
        • b.
        • c.
          kinesthesia and joint position sense
        • d.
      • #3.
        Two properties measured were
        • a.
          TTDPM and RPP
        • b.
          AROM and PROM
        • c.
          MMT and 2PD
        • d.
          IBM and GNP
      • #4.
        The strongest reliability was found to be
        • a.
        • b.
        • c.
        • d.
      • #5.
        Shoulder proprioception assessment remains a subject of psychometric contention
        • a.
        • b.
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.