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

Kevin Hall,Jeremy Lewis,Colette Ridehalgh,Ann Moore

doi:10.1186/s40945-020-00084-w

Abstract

BackgroundAlthough 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.MethodsA 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.ResultsAll 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°.ConclusionIn 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.

Highlights

Posterior shoulder tightness (PST) has been associated with shoulder pathology and altered glenohumeral joint kinematics, uncertainty remains regarding its cause and definition
standard error of measurement (SEM) ranged from 3.5–4.8 degrees and Minimum Detectable Change (MDC) ranged from 9.7–13.3 degrees
posterior shoulder tightness (PST) has been implicated in many shoulder conditions and can be identified using three clinical tests: horizontal adduction in supine (HorAdd), glenohumeral joint internal rotation (GHj-internal rotation (IR)) and Low flexion (LF)

Summary

Introduction

Posterior shoulder tightness (PST) has been associated with shoulder pathology and altered glenohumeral joint kinematics, uncertainty remains regarding its cause and definition. 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. Posterior shoulder tightness (PST) has been proposed as an important physical impairment in the management of the athletic shoulder [5,6,7] and increasingly in the nonsporting shoulder [8, 9]. 2. Shoulder internal rotation at 90-degrees abduction (GHj-IR). Shoulder internal rotation at 60 degrees of shoulder flexion (LF)

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