Advertisement

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

Published:February 28, 2022DOI:https://doi.org/10.1016/j.jht.2022.01.005

      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

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Hand Therapy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Clarkson HM.
        Joint Motion and Function Assessment: A Research-Based Practical Guide.
        Lippincott Williams & Wilkins, Philadelphia2005
        • Short N
        • Mays M
        • Ford R
        • Fahrney E.
        Proposed method for goniometric measurement of scapular protraction and retraction.
        J Hand Ther. 2021; 34: 148-150https://doi.org/10.1016/j.jht.2019.02.002
        • Dayanidhi S
        • Orlin M
        • Kozin S
        • Duff S
        • Karduna A.
        Scapular kinematics during humeral elevation in adults and children.
        Clin Biomech (Bristol, Avon). 2005; 20: 600-606https://doi.org/10.1016/j.clinbiomech.2005.03.002
        • Kinesiology Oatis CA.
        The Mechanics and Pathomechanics of Human Movement.
        3rd ed. Lippincott Williams & Wilkins, Philadelphia, PA2017
        • Smith J
        • Kotajarvi BR
        • Padgett DJ
        • Eischen JJ.
        Effect of scapular protraction and retraction on isometric shoulder elevation strength.
        Arch Phys Med Rehabil. 2002; 83: 367-370https://doi.org/10.1053/apmr.2002.29666
        • Gates DH
        • Walters LS
        • Cowley J
        • Wilken JM
        • Resnik L.
        Range of motion requirements for upper-limb activities of daily living.
        Am J Occup Ther. 2016; 70 (7001350010p1-7001350010p10)https://doi.org/10.5014/ajot.2016.015487
      1. American Occupational Therapy Association. Occupational Therapy Practice Framework: Domain & Process. 4th ed. Am J Occup Ther. 2014;70(Suppl. 2): 7412410010. doi:10.5014/ajot.2020.74S2001.

        • Paine RM
        • Voight M.
        The role of the scapula.
        J Orthop Sports Phys Ther. 1993; 18: 386-391https://doi.org/10.2519/jospt.1993.18.1.386
        • Pieniazek M
        • Chwała W
        • Szczechowicz J
        Pelczar-Pieniazek M. Upper limb joint mobility ranges during activities of daily living determined by three-dimensional motion analysis–preliminary report.
        Ortop Traumatol Rehabil. 2007; 9: 413-422
        • Oosterwijk AM
        • Nieuwenhuis MK
        • van der Schans CP
        • Mouton LJ.
        Shoulder and elbow range of motion for the performance of activities of daily living: A systematic review.
        Physiother Theory Pract. 2018; 34: 505-528https://doi.org/10.1080/09593985.2017.1422206
        • Kibler WB.
        The role of the scapula in athletic shoulder function.
        Am J Sports Med. 1998; 26: 325-337https://doi.org/10.1177/03635465980260022801
        • Shadmehr A
        • Azarsa MH
        • Jalaie S.
        Inter- and intrarater reliability of modified lateral scapular slide test in healthy athletic men.
        Biomed Res Int. 2014; (2014)384149https://doi.org/10.1155/2014/384149
        • Sree SD.
        To Evaluate Scapulohumeral Rhythm in Scapular Dyskinesia in Software Professionals with Neck Pain.
        Indian J Physiother Occup Ther. 2020; 14: 207-212https://doi.org/10.5958/0973-5674.2020.00037.4
        • Chu Y
        • Akins J
        • Lovalekar M
        • Tashman S
        • Lephart S
        • Sell T.
        Validation of a video-based motion analysis technique in 3-D dynamic scapular kinematic measurements.
        J Biomech. 2012; 45: 2462-2466https://doi.org/10.1016/j.jbiomech.2012.06.025
        • Johnson GR
        • Stuart PR
        • Mitchell S.
        A method for the measurement of three-dimensional scapular movement.
        Clin Biomech (Bristol, Avon). 1993; 8: 269-273https://doi.org/10.1016/0268-0033(93)90037-I
      2. Short N, Almonreoder T, Mays M, Baist A, Clifton T, Horty A, Kosty M, Olson C, & Patel R. Inter-rater reliability of a novel goniometric technique to measure scapular protraction and retraction. Am J Occ Ther. In press.

        • MacDermid JC
        • Chesworth BM
        • Patterson S
        • Roth JH.
        Intratester and intertester reliability of goniometric measurement of passive lateral shoulder rotation.
        J Hand Ther. 1999; 12: 187-192https://doi.org/10.1016/s0894-1130(99)80045-3
        • Shrout PE
        • Fleiss JL.
        Intraclass correlations: uses in assessing rater reliability.
        Psychol Methods. 1996; 1: 30-46
        • Koo TK
        • Li MY.
        A guideline of selecting and reporting intraclass correlation coefficients for reliability research.
        J Chiropr Med. 2016; 15: 155-163
        • Lee P
        • Liu C-H
        • Fan C-W
        • Lu C-P
        • Lu W-S
        • Hsieh C-L.
        The test-retest reliability and the minimal detectable change of the Purdue pegboard test in schizophrenia.
        J Formos Med Assoc. 2013; 112: 332-337
        • Proud EL
        • Bilney B
        • Miller KJ
        • Morris ME
        • McGinley JL.
        Measuring hand dexterity in people with Parkinson's disease: reliability of pegboard tests.
        Am J Occup Ther. 2019; 737304205050p8
        • Reissner L.
        • Fischer G.
        • List R.
        • Taylor W.R.
        • Giovanoli P.
        • Calcagni M.
        Minimal detectable difference of the finger and wrist range of motion: comparison of goniometry and 3D motion analysis.
        J Ortho Surg Res. 2019; 14: 1-10

      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
      • # 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.
          15°
        • c.
        • d.
          10°
      • # 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
      • # 5.
        The authors were reluctant to claim goniometry reliable for measuring scapular retraction and protraction
        • a.
          true
        • b.
          false
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.