Abstract

BackgroundAbnormal scapular displacements during arm elevation have been observed in people with shoulder impingement syndrome. These abnormal scapular displacements were evaluated using different methods and instruments allowing a 3-dimensional representation of the scapular kinematics. The validity and the intrasession reliability have been shown for the majority of these methods for healthy people. However, the intersession reliability on healthy people and people with impaired shoulders is not well documented. This measurement property needs to be assessed before using such methods in longitudinal comparative studies. The objective of this study is to evaluate the intra and intersession reliability of 3-dimensional scapular attitudes measured at different arm positions in healthy people and to explore the same measurement properties in people with shoulder impingement syndrome using the Optotrak Probing System.MethodsThree-dimensional scapular attitudes were measured twice (test and retest interspaced by one week) on fifteen healthy subjects (mean age 37.3 years) and eight subjects with subacromial shoulder impingement syndrome (mean age 46.1 years) in three arm positions (arm at rest, 70° of humerothoracic flexion and 90° of humerothoracic abduction) using the Optotrak Probing System. Two different methods of calculation of 3-dimensional scapular attitudes were used: relative to the position of the scapula at rest and relative to the trunk. Intraclass correlation coefficient (ICC) and standard error of measure (SEM) were used to estimate intra and intersession reliability.ResultsFor both groups, the reliability of the three-dimensional scapular attitudes for elevation positions was very good during the same session (ICCs from 0.84 to 0.99; SEM from 0.6° to 1.9°) and good to very good between sessions (ICCs from 0.62 to 0.97; SEM from 1.2° to 4.2°) when using the method of calculation relative to the trunk. Higher levels of intersession reliability were found for the method of calculation relative to the trunk in anterior-posterior tilting at 70° of flexion compared to the method of calculation relative to the scapula at rest.ConclusionThe estimation of three-dimensional scapular attitudes using the method of calculation relative to the trunk is reproducible in the three arm positions evaluated and can be used to document the scapular behavior.

Highlights

  • Abnormal scapular displacements during arm elevation have been observed in people with shoulder impingement syndrome

  • The level of reliability obtained when using two different methods of calculation of relative movement was assessed for the healthy subjects

  • Reliability of both methods was good to very good (ICCs from 0.73 to 0.96 with 95% confidence interval (95%CI) from 0.50 to 0.99 and standard error of measure (SEM) from 0.9° to 2.4° with 95%CI from 0.7° to 3.2°)

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Summary

Introduction

Abnormal scapular displacements during arm elevation have been observed in people with shoulder impingement syndrome. The objective of this study is to evaluate the intra and intersession reliability of 3-dimensional scapular attitudes measured at different arm positions in healthy people and to explore the same measurement properties in people with shoulder impingement syndrome using the Optotrak Probing System. More attention has been given to characterize scapular mobility in shoulder dysfunctions [1,2] Shoulder impairments, such as subacromial shoulder impingement syndrome (SIS), have been associated with abnormal movement of the scapula during elevation of the arm [1,2,3,4,5,6]. According to the International Society of Biomechanics (ISB) recommendations [7], the three scapular rotations are defined as: lateral/ medial rotation (L-MR) ( called upward/downward rotation or external/internal rotation), anterior/posterior tilting (A-PT) ( called posterior/anterior tilting [8]), and protraction/retraction (PRO-RET) ( called external/internal rotation or anterior/posterior transverse rotation)

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