A Reliability Study of Measurement Techniques to Determine Static Scapular Position

Abstract

T he shoulder girdle is an arrangement of three bones, four articulations, and numerous muscles which must interact in a highly coordinated and complex manner in order to elevate the arm and position the hand for use. Because the glenohumeral joint is highly mobile and inherently unstable, it is essential that the scapula and corresponding musculature perform several crucial functions. While some authors (3,12) state that normal scapular orientation at rest maintains the glenoid surface in an u p ward tilt which enhances passive stability of the glenohumeral joint, others (1 1,16) state that the resting position of the glenoid fossa is downward. During elevation of the arm, the scapula must follow the humeral head with a lateral or upward rotation in order to facilitate congruency of the glenohumeral joint and, thus, maximize stability. It is also imperative that the acromion process elevate and rotate in relation to the greater tuberosity of the humerus in order to avoid impingement of soft tissues in the subacromial space. In addition to demands for mobility, the scapula must also be capable of dynamic stability during arm elevation in order to afford the movers of the glenohumeral joint a stable base with which to position the arm.

A Clinical Method for Identifying Scapular Dyskinesis, Part 1: Reliability

“…Abnormal scapular mechanics are present among some persons with subacromial impingement and shoulder instability, yet a validated, clinically feasible method of identifying scapular dysfunction is lacking. 1,4,7 Clinical measures of scapular position based on side-toside differences of linear measures (from the spine to the medial border of the scapula) have lacked reliability, 8,9 and measures of linear asymmetry in athletes may not indicate dysfunction. 10 Additionally, linear measures taken at static arm positions fail to capture the 3-D motion patterns present during dynamic upper extremity movement, as in overhead occupational activity or sports.…”

Scapulohumeral control after stroke: A preliminary study of the test-retest reliability and discriminative validity of a clinical scapular protocol (ClinScaP)

“…In this way, it enables therapists to clinically identify scapular characteristics or dysfunctions, which could be related to various levels of PAF. The included tests in the ClinScaP were chosen based on their acceptable psychometric properties in musculoskeletal rehabilitation and on our assumption that these tests were related to a specific scapular rotation (DiVeta et al, 1990;Gibson, Goebel, Jordan, Kegerreis, & Worrell, 1995;Lluch et al, 2014;Nijs et al, 2005;Struyf, Meeus, et al, 2014;Struyf et al, 2009;Watson et al, 2005). We furthermore opted to add static as well as dynamic tests, deemed feasible for IwS, even with a low PAF.…”

Measurement Errors of a Test to Determine the Scapular Position Using a Tape Measure

“…These measurement methods can be readily applied using a tape measure and are frequently employed in clinical practice. Gibson et al 4) and T'Jonck et al 5) verified the intra-and inter-measurer reliabilities of these methods, but there has been no report on measurement error. Moreover, Kibler LSST is applicable only for upward and downward scapular rotations, and the DiVeta test is only applicable in the one direction, abduction / adduction; thus, 3-dimensional evaluation of the scapula is difficult.…”