Department of Physical Therapy, University of Dayton, Dayton, OH, USA.
Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha, Nebraska, USA.
J Man Manip Ther. 2021 Dec;29(6):360-366. doi: 10.1080/10669817.2021.1930861. Epub 2021 May 24.
Humeral retroversion alters range of motion and has been linked to injury risk. Clinically,palpation of the bicipital groove is used to quantify humeral torsion, but the accuracy of this procedure has not been fully examined. The purpose of this study was to investigate the relationship between clinical and diagnostic ultrasound (US) assessment of humeral torsion while considering shoulder position of the participant and clinical expertise of the examiner.
Seventeen participants (34 shoulders, 16/17 right handed, 10/17 history of throwing) were recruited. US was assessed by an experienced assessor. Two clinical assessments of humeral torsion were performed by two assessors of different experience (expert and novice). Humeral torsion was assessed at 90 degrees shoulder abduction (Palp90) and 45 degrees shoulder abduction (Palp45). Within assessor intraclass correlation coefficients (ICC (3, 1) were calculated. Correlation coefficients (Pearson's) were generated to determine relationship between clinical and US examination findings.
Intra-rater reliability for clinical tests were good (ICCs .73 - .92) for both raters. Of the palpation tests, only the expert assessor was significantly correlated to the US measurement (p<.001) at Palp45 (r = .64) and Palp90 (r = .62). For the expert, there was a significantly lower angle calculated for Palp45 compared to Palp90 (p<.001).
The accuracy of both palpation methods for assessing humeral retrotorsion may depend on the training background of the assessor. Further, the glenohumeral position of the patient during palpation should be consistent for the purposes of repeated testing.
肱骨后旋改变活动范围，并与受伤风险相关。临床上，通过触诊二头肌沟来量化肱骨扭转，但该过程的准确性尚未得到充分检验。本研究旨在探讨在考虑参与者肩部位置和检查者临床经验的情况下，临床和诊断超声（US）评估肱骨扭转之间的关系。
招募了 17 名参与者（34 个肩部，16/17 为右利手，10/17 有投掷史）。由有经验的评估者进行 US 评估。两名经验不同的评估者（专家和新手）进行了两次肱骨扭转的临床评估。在 90 度肩部外展（Palp90）和 45 度肩部外展（Palp45）时评估肱骨扭转。计算了内部评估者之间的组内相关系数（ICC（3,1）。生成相关系数（Pearson's）以确定临床和 US 检查结果之间的关系。
两位评估者的临床测试的内部信度均较好（ICC.73-.92）。在触诊测试中，只有专家评估者与 US 测量值（p<.001）在 Palp45（r =.64）和 Palp90（r =.62）之间具有显著相关性。对于专家来说，与 Palp90 相比，Palp45 计算出的角度明显较低（p<.001）。
评估肱骨后旋的两种触诊方法的准确性可能取决于评估者的培训背景。此外，在触诊时，患者的盂肱关节位置应保持一致，以便进行重复测试。
