Orthopaedic Physical Therapy Practice
Study Design: Retrospective study. Objectives: To determine the reliability of measuring the perpendicular distance between the posterolateral acromion process and examination table to estimate passive shoulder protraction in student physical therapists.
Background: Previous research has identified scapular dyskinesis to be associated with musculoskeletal shoulder pain, and commonly addressed by physical therapists. Tightness of the anterior shoulder muscles may be associated with scapular movement abnormality. Thus, reliable clinical measurements for anterior shoulder muscle length are imporrant for physical therapy care.
Methods: After a 1 0-minute review session, two measurements of the distance between the posterior acromion process and examination table were obtained for both the dominant shoulders and nondominant shoulders in 12 nondisabled individuals (6 females, and 6 males age: 25.0 ± 2.4 years) by 12 student physical therapist examiners. A complete set of measurements from 10 subjects were available for analysis.
Results: Mean (±standard deviation) measurements for the dominant (D) shoulder were 7.6 ± 2.0cm for Trial #1 and 7.4 ± 2.0 em for Trial #2, and 7.5 ± 2.lcm for Trial #l and 7.4 ± 2.3cm for Trial #2 for the nondominant (ND) shoulder. Tightness was determined in 85% and 86% for D and ND shoulders, respectively. The measurement demonstrated good intra-rater reliability (D: intradass correlation, formula 2,1; ICC2 _ 1 .751, 95% confidence interval; Cl: .628-.861; ND: .764, 95% CI: .645-.869) and moderate to good inter-rater reliability (D: ICC2 , 1 .651, 95% CI: .445-.876; ND: ICC2•1 = .733, 95% CI: .548-.911) considered as a continuous variable, <}nd good percent agreement both within raters (94%) and between raters (90%) as a binomial variable. The coefficient of variation was acceptable (D: 25.8, ND: 28.4%). Standard error of measure was 0.99 em for D shoulders and 1.01 em for ND shoulders. Minimum detectable change outside the 95% confidence interval was 2.74 em forD shoulders and 2.80 em for ND shoulders.
Conclusion: Measurement of the perpendicular distance between the posterolateral acromion process and examination table is a reliable method to estimate passive shoulder protraction in novice clinicians.
Taylor, BD, Norris, AM, Mertz, ZJ, Davenport, TE. Reliability of posterolateral acromion process to examination table measurement to estimate shoulder protraction contracture. Orthopaedic Physical Therapy Practice. 2015;27(2):108-111. © 2015, Orthopaedic Section, APTA, Inc.