Evaluation of Clinical Assessment Methods for Scapular Dyskinesis

Reliability of Scapular Classification in Examination of Professional Baseball Players

“…In the clinical setting, methods used to evaluate the scapula rely on visual observation and a keen understanding of the normal mechanics and pathomechanics of scapular motion. We used a clinical method of visual observation to evaluate uninjured professional baseball players for the presence of scapular dyskinesis using a scapular classification system recommended in the literature [6][7][8]19]. The presence of subtle scapular dyskinesis identified in laboratory studies [13,15] in overhead athletes coupled with the reported consequences of scapular dyskinesis on high-level overhead upper extremity function [6,7,9] highlight the importance of early identification and recognition of scapular pathology in overhead athletes to both prevent injury and optimize performance.…”

“…Five full repetitions were performed and used for observation and analysis. This scapular test has been recommended and used in the literature for evaluating scapular humeral rhythm in athletes and in patients with glenohumeral dysfunction [7,8,12,18,19].…”

“…Interrater reliability was examined using the generalized k statistic [3] for multiple raters for three separate analyses: (1) classifying each scapula into one of the four types (I-IV); (2) classifying each scapula as being abnormal (Types I-III) or normal (Type IV); and (3) classifying both scapula as both being symmetric (both normal or both abnormal) or asymmetric (one normal, one abnormal) [19]. Ninety-five percent confidence intervals were computed using the product of the corrected kappa standard error [4] and 1.96 [17].…”

“…The descriptive term scapular winging refers to the severe dissociation of the scapula from the thoracic wall and is most often caused by loss of function of the long thoracic nerve [6,7,14]. More detailed descriptions of subtle scapular dysfunction and classifications appear in several publications by Kibler and colleagues [6][7][8]19].…”

“…Additionally, overhead athletes often present with subtle scapular dysfunction, not gross disassociation of the scapula away from the thorax as is seen in patients with nerve injury and other conditions [6,7,19]. Use of a classification system to evaluate subtle scapular dysfunction has been advocated and requires study on this population of overhead athletes who present with subtle scapular movement deviations in laboratory studies [5,9,10,13,15].…”