Physiotherapy Associates Scottsdale Sports Clinic, 9917 N 95th Street, Scottsdale, AZ 85258, USA.
Clin Orthop Relat Res. 2012 Jun;470(6):1540-4. doi: 10.1007/s11999-011-2216-0.
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.
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).
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.
We found low reliability of visual observation and classification of scapular movement.
Current evaluation strategies for evaluating subtle scapular abnormalities are limited.
Level III, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
临床评估肩胛胸关节具有挑战性。为了确定肩胛骨运动障碍，临床医生通常会在自主进行上肢运动时观察肩胛骨的运动和协调性。但是，尚不清楚这种方法是否可靠。
问题/目的：因此，我们确定了一种肩胛分类系统在检查职业棒球运动员中的可靠性。
71 名年龄在 18 至 32 岁之间的健康未受伤的职业棒球运动员自愿参加。我们使用数码摄像机拍摄了五次举起 2 磅重物时的肩胛骨平面抬高运动。然后，四名检查者独立地在视频上对运动进行分类，分为以下四种类型之一。使用κ（k）统计量进行了以下方面的组内可靠性分析：（1）将每侧肩胛骨分为四种类型之一；（2）将每侧肩胛骨分为异常（I-III 型）或正常（IV 型）；（3）将双侧肩胛骨均分为对称（双侧均正常或双侧均异常）或不对称（一侧正常，一侧异常）。
我们发现所有分析的可靠性均较低。在将每侧肩胛骨分为四种类型之一时，左侧的可靠性为 k = 0.245，右侧的可靠性为 k = 0.186。当考虑二分类（异常与正常）时，左侧的可靠性为 k = 0.264，右侧的可靠性为 k = 0.157。双侧对称/不对称的可靠性为 k = 0.084。
我们发现视觉观察和肩胛骨运动分类的可靠性较低。
目前评估肩胛骨细微异常的评估策略有限。
III 级，诊断研究。欲了解完整的证据水平描述，请参见作者指南。
