Highlights
- •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.
Abstract
Study Design
Observational, descriptive design.
Background
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.
Purpose
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.
Methods
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.
Results
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.
Discussion
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.
Conclusion
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.
Keywords
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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 JHTReadforCredit.com. 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
- a.
- # 2.Subjects were
- a.post CVA patients
- b.all actual patients
- c.50% normal and 50% actual patients
- d.all normals
- a.
- # 3.The authors cited the standard of less than _______ of variance as acceptable reliability
- a.2°
- b.15°
- c.5°
- d.10°
- a.
- # 4.ROM was measured with
- a.videography
- b.a plastic 12” goniometer
- c.a stainless steel 18” new age goniometer
- d.X-ray assisted goniometric placement
- a.
- # 5.The authors were reluctant to claim goniometry reliable for measuring scapular retraction and protraction
- a.true
- b.false
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Published online: February 28, 2022
Accepted:
January 21,
2022
Received in revised form:
December 29,
2021
Received:
February 23,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
