McClure Philip, Tate Angela R, Kareha Stephen, Irwin Dominic, Zlupko Erica
Arcadia University, Department of Physical Therapy, Glenside, PA 19038, USA.
J Athl Train. 2009 Mar-Apr;44(2):160-4. doi: 10.4085/1062-6050-44.2.160.
Shoulder injuries are common in athletes involved in overhead sports, and scapular dyskinesis is believed to be one causative factor in these injuries. Many authors assert that abnormal scapular motion, so-called dyskinesis, is related to shoulder injury, but evidence from 3-dimensional measurement studies regarding this relationship is mixed. Reliable and valid clinical methods for detecting scapular dyskinesis are lacking.
To determine the interrater reliability of a new test designed to detect abnormal scapular motion.
Correlation design using ratings from multiple pairs of testers.
University athletic training facilities.
A sample of 142 athletes (from National Collegiate Athletic Association Divisions I and III) participating in sports requiring intense overhead arm use.
INTERVENTION(S): Participants were videotaped from the posterior aspect while performing 5 repetitions of bilateral, weighted (1.4-kg [3-lb] or 2.3-kg [5-lb]) shoulder flexion and frontal-plane abduction. Videotapes from randomly chosen participants were subsequently viewed and independently rated for the presence of scapular dyskinesis by 6 raters (3 pairs), with each pair rating 30 different participants. Raters were trained to detect scapular dyskinesis using a self-instructional format with standardized operational definitions and videotaped examples of normal and abnormal motion.
MAIN OUTCOME MEASURE(S): Scapular dyskinesis was defined as the presence of either winging or dysrhythmia. Right and left sides were rated independently as normal, subtle, or obvious dyskinesis. We calculated percentage of agreement and weighted kappa (kappa(w)) coefficients to determine reliability.
Percentage of agreement was between 75% and 82%, and kappa(w) ranged from 0.48 to 0.61.
The test for scapular dyskinesis showed satisfactory reliability for clinical use in a sample of overhead athletes known to be at increased risk for shoulder symptoms.
肩部损伤在从事过头运动的运动员中很常见，肩胛运动障碍被认为是这些损伤的一个致病因素。许多作者断言，异常的肩胛运动，即所谓的运动障碍，与肩部损伤有关，但三维测量研究关于这种关系的证据并不一致。目前缺乏可靠且有效的检测肩胛运动障碍的临床方法。
确定一种旨在检测异常肩胛运动的新测试的评分者间信度。
采用多组测试者评分的相关性设计。
大学体育训练设施。
142名运动员（来自美国国家大学体育协会第一和第三分区）的样本，他们参与需要频繁进行过头手臂动作的运动。
参与者在进行5次双侧、负重（1.4千克[3磅]或2.3千克[5磅]）肩部屈曲和额状面外展动作时，从后方进行录像。随后，随机选择参与者的录像带由6名评分者（3组）独立观看并对肩胛运动障碍的存在情况进行评分，每组评分30名不同的参与者。评分者通过自学形式接受培训，学习使用标准化的操作定义以及正常和异常运动的录像示例来检测肩胛运动障碍。
肩胛运动障碍被定义为存在翼状肩胛或节律异常。左右两侧分别独立评定为正常、轻微或明显运动障碍。我们计算一致性百分比和加权kappa（kappa(w)）系数以确定信度。
一致性百分比在75%至82%之间，kappa(w)范围为0.48至0.61。
对于已知肩部症状风险增加的过头运动运动员样本，肩胛运动障碍测试在临床应用中显示出令人满意的信度。
