Heick John D, Haggerty Jenna, Manske Robert C
Northern Arizona University.
Wichita State University.
Int J Sports Phys Ther. 2021 Jun 1;16(3):835-843. doi: 10.26603/001c.23425.
In orthopaedic practice, it is well established that weak scapular stabilizers and an unstable scapula is related to shoulder dysfunction. Faulty scapular position has been linked to decreased scapular stability and is thought to be a result of weak or unbalanced timing in the recruitment of scapulothoracic dynamic stabilizing muscles. Kibler has described a four-type classification of scapulothoracic dysfunction. Functional performance testing is used to objectively measure activities that simulate various desired activities. The reliability of assessing the four static scapular positions may be important in diagnosing shoulder dysfunction. An understanding of the scapular position and its relationship to functional performance testing is needed.
The purpose of this study was to determine if a static scapular test, the Kibler scapula classification, in healthy participants affects the ability to perform a closed chain functional test that involves the use of the scapula and the upper extremity, the Davies Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST). A secondary analysis was performed to evaluate the reliability of a student physical therapist and an experienced physical therapist to identify scapular type by observation.
Multicenter, single session descriptive cohort.
Sixty-one healthy participants (33 males, 28 females; mean age 24.19±2.61) completed testing across two locations in one testing session. Blood pressure and heart rate as well as height and weight were measured for each participant. Participants were classified by visual observation of Kibler scapular classification. The average number of CKUEST touches, a normalized score, and a power score were calculated for each participant. Three trials were performed and participants were required to take a 45-second rest break between each CKCUEST trial.
One way analysis of variance (ANOVA) showed statistically significant differences in Type I and Type IV Kibler scapula classification for the CKCUEST power score, however when an ANCOVA controlled for body mass index, there was no statistically significant difference. A strong correlation r=.94 was observed between student and experienced physical therapist in evaluating all four types of Kibler scapular classification.
Visually observed Kibler scapular position does not affect the ability to perform the Davies CKCUEST in healthy young adults. The ability to identify Kibler scapular position was reliable between student and experienced physical therapists. Additional studies are required to identify the usefulness of the Kibler scapular position classification.
2b: Individual Cohort Study.
在骨科实践中，肩胛稳定肌薄弱和肩胛骨不稳定与肩部功能障碍密切相关，这一点已得到充分证实。肩胛骨位置异常与肩胛骨稳定性下降有关，被认为是肩胛胸壁动态稳定肌募集时力量薄弱或时机不平衡的结果。基布勒描述了肩胛胸壁功能障碍的四种类型分类。功能性能测试用于客观测量模拟各种预期活动的动作。评估肩胛骨四个静态位置的可靠性对于诊断肩部功能障碍可能很重要。需要了解肩胛骨位置及其与功能性能测试的关系。
本研究的目的是确定在健康受试者中，静态肩胛骨测试（基布勒肩胛骨分类）是否会影响进行涉及肩胛骨和上肢的闭链功能测试（戴维斯闭链上肢稳定性测试，CKCUEST）的能力。进行了一项二次分析，以评估学生物理治疗师和经验丰富的物理治疗师通过观察识别肩胛骨类型的可靠性。
多中心、单时段描述性队列研究。
61名健康受试者（33名男性，28名女性；平均年龄24.19±2.61岁）在一次测试时段内在两个地点完成测试。测量了每位受试者的血压、心率以及身高和体重。通过对基布勒肩胛骨分类的视觉观察对受试者进行分类。计算每位受试者的CKUEST触摸平均次数、标准化分数和功率分数。进行了三次试验，每次CKCUEST试验之间要求受试者休息45秒。
单因素方差分析（ANOVA）显示，对于CKCUEST功率分数，I型和IV型基布勒肩胛骨分类存在统计学显著差异，然而，当协方差分析（ANCOVA）控制体重指数时，没有统计学显著差异。在评估所有四种类型的基布勒肩胛骨分类时，学生物理治疗师和经验丰富的物理治疗师之间观察到强相关性r = 0.94。
在健康的年轻人中，通过视觉观察到的基布勒肩胛骨位置不会影响进行戴维斯CKCUEST的能力。学生物理治疗师和经验丰富的物理治疗师在识别基布勒肩胛骨位置方面的能力是可靠的。需要进一步研究以确定基布勒肩胛骨位置分类的有用性。
2b：个体队列研究。
Zotero 插件
