Abstract
The Scapula Reposition Test (SRT) is proposed to determine if a relationship exists between scapular dyskinesis and shoulder pathology. The purpose of this study was to evaluate intra-rater and inter-rater reliability of the SRT in subjects with rotator cuff tendinopathy and scapular dyskinesis. In addition, we compared subjective strength findings from the test to an objective measure made by dynamometry. The SRT was independently and randomly performed by two physical therapists in 42 subjects. The percent agreement, Cohen’s kappa (κ), maximum attainable κ, prevalence and bias indexes, and prevalence-adjusted-bias-adjusted kappa were used as intra- and inter-rater reliability estimates. Finally, the point-biserial correlation coefficient (rpb) was used for correlation analysis of objective and subjective strength findings. A moderate intra-rater (κ = 0.43; CI 95%, 0.14 to 0.73; p = 0.004) and poor inter-rater (κ = 0.08; CI 95%, −0.22 to 0.38; p = 0.61) agreement was found. Subjective strength changes during SRT and dynamometry were poorly correlated (rpb = 0.137; CI 95%, −0.175 to 0.423; p = 0.389). The SRT cannot be recommended for clinical practice. More studies evaluating its reliability are needed as well as further research on the capability of a rater to manually detect strength changes.
Highlights
Rotator cuff tendinopathy (RCT), subacromial pain syndrome, and/or rotator cuff related shoulder pain are the most common disorders of the shoulder, accounting for 44%–65% of all complaints of shoulder pain [1]
There is a lack of evidence showing good diagnostic accuracy of scapular dyskinesis orthopedic tests in detecting the presence of shoulder pain [4]. These findings lead to the conclusion that it is not sufficient to diagnose the presence of scapular dyskinesis; rather, one needs to discern when it is involved in patients’ symptomatology [5]
An intra- and inter-rater reliability study was conducted following the recommendations of the Guidelines for Reporting Reliability and Agreement Studies (GRRAS) [8]
Summary
Rotator cuff tendinopathy (RCT), subacromial pain syndrome, and/or rotator cuff related shoulder pain are the most common disorders of the shoulder, accounting for 44%–65% of all complaints of shoulder pain [1]. Scapular dyskinesis is defined as an alteration of the normal position and/or movement of the scapula [3]. There is currently insufficient evidence to support the claim that deviation from a ‘normal’ scapular position and/or movement contributes to RCT [2]. There is a lack of evidence showing good diagnostic accuracy of scapular dyskinesis orthopedic tests in detecting the presence of shoulder pain [4]. These findings lead to the conclusion that it is not sufficient to diagnose the presence of scapular dyskinesis; rather, one needs to discern when it is involved in patients’ symptomatology [5]
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