Research Article| Volume 35, ISSUE 2, P275-281, April 2022

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Intra-rater reliability of goniometry to measure scapular protraction and retraction

Published:February 28, 2022DOI:


      • Scapular mobility is uniquely challenging to assess and currently there is no reliable goniometric technique described in the literature to measure scapular protraction and retraction.
      • The current study examined intra and inter-rater reliability of a goniometric technique using the superior angle and acromion as landmarks to measure the position of the scapula relative to the frontal plane.
      • SEM for repeat measures by the expert and novice raters was < 4.5° and < 3.9°respectively, and SEM between evaluators was < 5.0°, demonstrating absolute reliability similar to that of other goniometric assessments.
      • Minimum detectable change (MDC) values as a percentage of the mean (% MDC), reflecting the degree of measurement error as a percentage of the available motion, ranged between 15.9-43.7% for intra-rater reliability and 21.9-52.8% for inter-rater reliability.


      Study Design

      Observational, descriptive design.


      Despite scapular mobility being essential for the completion of activities of daily living (ADLs), there is currently no established, a reliable goniometric technique to measure scapular protraction and retraction. A proposed method has shown clinically significant inter-rater reliability for a goniometric technique for these measurements.


      This observational descriptive study examined the intra-rater reliability of a goniometric technique to assess scapular protraction and retraction among a sample of healthy adults.


      An occupational therapist who is a certified hand therapist (CHT) and an occupational therapy student used goniometry to measure the neutral (resting), protracted, and retracted positions of the right and left scapula for a sample of healthy young adults (n = 54; a total of 108 data points for each measurement). These measurements were compared to analyze intra-rater and inter-rater reliability.


      For measurements of the scapula in neutral, protraction, and retraction, the standard error of measure (SEM) for repeat measures by the expert and novice raters was < 4.5° and < 3.9° respectively and ICC values ranged from poor to moderate (0.37-0.63). The SEM for measures between evaluators was < 5.0° and the ICC was poor (0.16-0.35). Minimum detectable change (MDC) values as a percentage of the mean (% MDC) ranged between 15.9 and 43.7% for intra-rater reliability and 21.9-52.8% for inter-rater reliability.


      The results of the study were mixed; variance of less than 5° for repeat measures by the same rater and measures between raters suggest clinically acceptable reliability. However, variance as a proportion of available motion (%MDC) demonstrates a broader range both above and below the threshold of 30% suggested for rehabilitation assessments.


      There are few efficient, reliable techniques to measure scapular mobility in clinical practice. The absolute reliability of goniometry to measure scapular protraction and retraction is similar to measurements of other joints. However, additional research and possible refinement of the technique is recommended to further address relative reliability and validity.


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      JHT Read for Credit

      Quiz: # 851

      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 two landmarks were the
        • a.
          the lateral angle and the acromion
        • b.
          acromion and the superior angle
        • c.
          the A/C joint and the inferior angle
        • d.
          scapular notch and the acromion
      • # 2.
        Subjects were
        • a.
          post CVA patients
        • b.
          all actual patients
        • c.
          50% normal and 50% actual patients
        • d.
          all normals
      • # 3.
        The authors cited the standard of less than _______ of variance as acceptable reliability
        • a.
        • b.
        • c.
        • d.
      • # 4.
        ROM was measured with
        • a.
        • b.
          a plastic 12” goniometer
        • c.
          a stainless steel 18” new age goniometer
        • d.
          X-ray assisted goniometric placement
      • # 5.
        The authors were reluctant to claim goniometry reliable for measuring scapular retraction and protraction
        • 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.