Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada; Graduate Program in Physical Therapy, Pontifícia Universidade Católica, Belo Horizonte, Brazil.
Physiotherapy. 2010 Mar;96(1):59-67. doi: 10.1016/j.physio.2009.06.007. Epub 2009 Sep 2.
Observation and measurement of the static position of the scapula is important for investigating both shoulder and neck pathology. Measurement of scapular position is complex and lacks a clinically useful instrument. The objective of this study was to investigate the reliability of the Palpation Meter (PALM) for measuring scapular position when the glenohumeral joint is held in various positions.
Thirty normal subjects were recruited for a test-retest reliability study. Three raters conducted measurements on two different occasions to estimate intra- and inter-rater reliability. The scapular positions evaluated in this study were: (1) the horizontal distance between the scapula and the spine in the scapular resting position and during elevation of the arm in the scapular plane; and (2) the vertical distance between C(7) and the acromion (C(7)-A). Intraclass correlation coefficient (ICC), standard error of measurement (SEM) and Bland and Altman limits of agreement were calculated.
Reliability values for measurements of the horizontal distance between the scapula and the spine were generally good for both intra-rater (ICC 0.81 to 0.89; SEM 0.56 to 1.17cm) and inter-rater (ICC 0.67 to 0.89; SEM 0.59 to 0.98cm) evaluation. Reliability values of measurement of depression of the acromion were also good for both intra-rater (ICC 0.72 to 0.78; SEM 0.66 to 0.79) and inter-rater (ICC 0.76; SEM 0.64) evaluation. No systematic bias was observed with Bland and Altman analysis.
The PALM is a reliable tool for the measurement of scapular positioning in a healthy sample. Future studies should be conducted to further investigate the clinometric properties of the PALM in patient populations before its clinical usefulness for measuring scapular position can be established.
观察和测量肩胛骨的静态位置对于研究肩部和颈部的病理学都很重要。肩胛骨位置的测量比较复杂，而且缺乏临床实用的工具。本研究的目的是研究在盂肱关节处于不同位置时，Palpation Meter（PALM）测量肩胛骨位置的可靠性。
30 名正常受试者参与了这项测试-再测试可靠性研究。3 名评估者在两次不同的评估中进行了测量，以评估组内和组间的可靠性。本研究评估了以下两种肩胛骨位置：（1）在肩胛骨休息位和肩外展时，肩胛骨与脊柱之间的水平距离；（2）C7 到肩峰的垂直距离（C7-A）。计算了组内相关系数（ICC）、测量标准误差（SEM）和 Bland 和 Altman 可接受范围。
在评估肩胛骨与脊柱之间的水平距离时，无论是组内（ICC 0.81 到 0.89；SEM 0.56 到 1.17cm）还是组间（ICC 0.67 到 0.89；SEM 0.59 到 0.98cm）评估，测量的可靠性值都比较好。在评估肩峰下降低时，评估的可靠性值也很好，无论是组内（ICC 0.72 到 0.78；SEM 0.66 到 0.79）还是组间（ICC 0.76；SEM 0.64）评估，可靠性值都比较好。Bland 和 Altman 分析没有显示出系统偏差。
PALM 是一种可靠的测量健康人群肩胛骨定位的工具。在确定其临床应用于测量肩胛骨位置的实用性之前，应进行进一步的研究，以进一步研究其在患者人群中的临床计量学特性。
