Scapular Dyskinesis: a Reliability and Validity Study of Novel Classification Test
Date Issued
2012
Date
2012
Author(s)
Huang, Tsun-Shun
Abstract
Background: Scapular dyskinesis are observable alternations in scapular position and the patterns of motion. Shoulder kinematics and scapular muscular activities alternations were found to be correlated with many shoulder disorders. In previous studies, there were several evaluation methods to assess scapular dyskinesis. However, it was not sufficient; for instance, the scapular displacement from the trunk only provides static measurement, and difficulty of using complicated devices in clinical settings. Therefore, visual-based clinical assessment to identify scapular dyskinesis need to be developed. In this study, we want to develop a novel integrated test to evaluate patients with scapular dyskinesis for clinical use. Objective: The purpose of this study was to investigate the reliability and validity of the novel scapular dyskinesis classification test. Study Design: Sixty subjects with unilateral shoulder pain will be recruited in this study. We used visual-based assessment combined palpation to classify the scapular movement of participants as 8 patterns (3 single abnormal scapular patterns: inferior angle of scapula prominence (pattern I), medial border of scapula prominence (pattern II), superior border of scapula prominence or aberrant scapulohumeral rhythm (pattern III); 4 mixed abnormal scapular patterns: 2 patterns combined (pattern I and II, pattern II and III, pattern I and III) and all 3 patterns combined (pattern I, II, and III); normal scapular movement pattern (pattern IV)) to investigate the reliability and validity of this method. In validity part, we analyzed whether different patterns of scapular dyskinesis corresponding to the alternation of the scapular kinematics and muscular activities. Main outcome measures: (1) 8 patterns of scapular movement (2) Scapular kinematics (scapular upward/ downward rotation, anterior/ posterior tipping and internal/ external rotation, elevation/ depression). (3) Scapular muscular activities (upper/ middle/ lower trapezius and serratus anterior). (4) Muscle force. Results: The novel scapular dyskinesis classification test reached moderate to substantial inter-rater reliability. In validity part, there were less scapular upward rotation (7°) and elevation (1.7 cm) in pattern III group in raising phase, and there was more scapular internal rotation (5°~7°) in pattern II group in lowering phase. Results from EMG data only showed significant difference in serratus anterior muscle (raising: increase 15~19%; lowering: decrease 8%). Conclusion: The novel scapular dyskinesis classification test reached satisfactory reliability. The validity of this test has been demonstrated that the alternations of scapular kinematics were found mostly in specific pattern of scapular dyskinesis group compared with normal pattern group in raising and lowering phase of arm elevation. EMG showed that only the alternation of serratus anterior muscle activity was found, which may be consistent with the fact of distinctive strategy of using scapular muscles by each subject.
Subjects
scapular dyskinesis
kinematics
muscular activities
clinical evaluation
reliability
Type
thesis
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