BACKGROUND: Clinically evaluating the scapulothoracic joint is challenging. To identify scapular dyskinesis, clinicians typically observe scapular motion and congruence during self-directed upper extremity movements. However, it is unclear whether this method is reliable. QUESTIONS/PURPOSES: We therefore determined the interrater reliability of a scapular classification system in the examination of professional baseball players. METHODS: Seventy-one healthy uninjured professional baseball players between the ages of 18 and 32 years volunteered to participate. We used a digital video camera to film five repetitions of scapular plane elevation while holding a 2-pound weight. Four examiners then independently classified the motions on video into one of four types. Interrater reliability analysis using the kappa (k) statistic was performed for: (1) classifying each scapula into one of the four types; (2) classifying each scapula as being abnormal (Types I-III) or normal (Type IV); and (3) classifying both scapula as both being symmetric (both normal or both abnormal) or asymmetric (one normal, one abnormal). RESULTS: We found low reliability for all analyses. In classifying each scapula as one of the four types, reliability was k = 0.245 for the left limb and k = 0.186 for the right limb. When considering the dichotomous classifications (abnormal versus normal), reliability was k = 0.264 for left and k = 0.157 for right. For bilateral symmetry/asymmetric, reliability was k = 0.084. CONCLUSION: We found low reliability of visual observation and classification of scapular movement. CLINICAL RELEVANCE: Current evaluation strategies for evaluating subtle scapular abnormalities are limited. LEVEL OF EVIDENCE: Level III, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
BACKGROUND: Clinically evaluating the scapulothoracic joint is challenging. To identify scapular dyskinesis, clinicians typically observe scapular motion and congruence during self-directed upper extremity movements. However, it is unclear whether this method is reliable. QUESTIONS/PURPOSES: We therefore determined the interrater reliability of a scapular classification system in the examination of professional baseball players. METHODS: Seventy-one healthy uninjured professional baseball players between the ages of 18 and 32 years volunteered to participate. We used a digital video camera to film five repetitions of scapular plane elevation while holding a 2-pound weight. Four examiners then independently classified the motions on video into one of four types. Interrater reliability analysis using the kappa (k) statistic was performed for: (1) classifying each scapula into one of the four types; (2) classifying each scapula as being abnormal (Types I-III) or normal (Type IV); and (3) classifying both scapula as both being symmetric (both normal or both abnormal) or asymmetric (one normal, one abnormal). RESULTS: We found low reliability for all analyses. In classifying each scapula as one of the four types, reliability was k = 0.245 for the left limb and k = 0.186 for the right limb. When considering the dichotomous classifications (abnormal versus normal), reliability was k = 0.264 for left and k = 0.157 for right. For bilateral symmetry/asymmetric, reliability was k = 0.084. CONCLUSION: We found low reliability of visual observation and classification of scapular movement. CLINICAL RELEVANCE: Current evaluation strategies for evaluating subtle scapular abnormalities are limited. LEVEL OF EVIDENCE: Level III, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
Authors: W Ben Kibler; Tim L Uhl; Jackson W q Maddux; Paul V Brooks; Brian Zeller; John McMullen Journal: J Shoulder Elbow Surg Date: 2002 Nov-Dec Impact factor: 3.019
Authors: Joseph B Myers; Kevin G Laudner; Maria R Pasquale; James P Bradley; Scott M Lephart Journal: Am J Sports Med Date: 2005-02 Impact factor: 6.202
Authors: Douglas A Bourne; Anthony M T Choo; William D Regan; Donna L MacIntyre; Thomas R Oxland Journal: J Shoulder Elbow Surg Date: 2006-11-16 Impact factor: 3.019