Double calibration: an accurate, reliable and easy-to-use method for 3D scapular motion analysis.

The most recent non-invasive methods for the recording of scapular motion are based on an acromion marker (AM) set and a single calibration (SC) of the scapula in a resting position. However, this method fails to accurately measure scapular kinematics above 90° of arm elevation, due to soft tissue artifacts of the skin and muscles covering the acromion. The aim of this study was to evaluate the accuracy, and inter-trial and inter-session repeatability of a double calibration method (DC) in comparison with SC. The SC and DC data were measured with an optoelectronic system during arm flexion and abduction at different angles of elevation (0-180°). They were compared with palpation of the scapula using a scapula locator. DC data was not significantly different from palpation for 5/6 axes of rotation tested (Y, X, and Z in abduction and flexion), where as SC showed significant differences for 5/6 axes. The root mean square errors ranged from 2.96° to 4.48° for DC and from 6° to 9.19° for SC. The inter-trial repeatability was good to excellent for SC and DC. The inter-session repeatability was moderate to excellent for SC and moderate to good for DC. Coupling AM and DC is an easy-to-use method, which yields accurate and reliable measurements of scapular kinematics for the complete range of arm motion. It can be applied to the measurement of shoulder motion in many fields (sports, orthopaedics, and rehabilitation), especially when large ranges of arm motion are required.