Posterior shoulder tightness; an intersession reliability study of 3 clinical tests

Abstract

Background: Although posterior shoulder tightness (PST) has been associated with shoulder pathology and altered glenohumeral joint kinematics, uncertainty remains regarding its cause and definition. To understand the efficacy of treatments for PST, it must be possible to identify people with PST for the purposes of research and clinical decision-making. Clinical tests for PST must demonstrate acceptable levels of measurement reliability in order to identify the condition and to evaluate the response to intervention. There is currently a lack of research describing intersession reliability for measures of PST. The aim of this study was to quantify the inter-session reliability for three clinical tests used to identify PST over a 6-10 week interval. Methods: A convenience sample of 26 asymptomatic adult participants (52 shoulders) were recruited from a university setting over a five-month duration. Participants attended the human movement laboratory for measurement of glenohumeral joint internal rotation, horizontal adduction and low flexion on two occasions separated by an interval of 6-10 weeks. Intra-class correlation coefficients were calculated from the mean square values derived from the within-subject, single factor (repeated measures) ANOVA. Test-retest measurement stability was evaluated by calculating the standard error of measurement and the minimum detectable change for each measurement. Results: All 3 tests demonstrated good intersession intra-rater reliability (0.86-0.88), and the standard error of measurement (95%) were 7.3°for glenohumeral horizontal adduction, 9.4°for internal rotation, and 6.9°for low flexion. The minimum detectable change for glenohumeral horizontal adduction was 10.2°, internal rotation was 13.3°, and low flexion was 9.7°. Conclusion: In this population of people without symptoms, the 3 measures of PST all demonstrated acceptable inter-session reliability. The standard error of measurement and minimum detectable change results can be used to determine if a change in measures of PST are due to measurement error or an actual change over time.

RETRACTED: Effect of Morphologic Changes in the Posterior Glenoid Rim on Rotator Cuff Impingement in Baseball Players

“…The examiner measured the passive maximum external and internal rotation ROMs of the shoulder. The examiner prevented compensatory movements of the scapulothoracic joint, such as scapular anterior and posterior tipping, by pressing the coracoid process of the scapula [9,13,19,20].…”

“…The GIRD was calculated from the difference in the maximum shoulder IR between the throwing and nonthrowing shoulders. A higher GIRD represents more posterior shoulder tightness of the throwing shoulder [9,12,13,[19][20][21].…”

Comparison of specific and non-specific treatment approaches for individuals with posterior capsule tightness and shoulder impingement symptoms: A randomized controlled trial

“…38 The LFT is a valid and reliable measurement specific to the posterior glenohumeral capsule. [37][38][39][40] For kinematic data collection, participants were also required to have »150°of active arm elevation.…”

The Contribution of Posterior Capsule Hypertrophy to Soft Tissue Glenohumeral Internal Rotation Deficit in Healthy Pitchers

“…Posterior shoulder tightness can represent tightness of the posterior rotator cuff and/or thickness/tightness of the posterior capsule. 13,14,16-18,22,28,30 Unfortunately, no methodology exists to isolate and accurately measure posterior rotator cuff tightness; therefore, an assessment of this specific tissue adaptation is currently not available. Fortunately, PCT has been previously assessed with the use of diagnostic ultrasound and elastography, demonstrating validity and reliability.…”