title: Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review.
abstract: The aims were to compile a schematic overview of clinical scapular assessment methods and critically appraise the methodological quality of the involved studies. A systematic, computer-assisted literature search using Medline, CINAHL, SportDiscus and EMBASE was performed from inception to October 2013. Reference lists in articles were also screened for publications. From 50 articles, 54 method names were identified and categorized into three groups: (1) Static positioning assessment (n = 19); (2) Semi-dynamic (n = 13); and (3) Dynamic functional assessment (n = 22). Fifteen studies were excluded for evaluation due to no/few clinimetric results, leaving 35 studies for evaluation. Graded according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN checklist), the methodological quality in the reliability and validity domains was "fair" (57%) to "poor" (43%), with only one study rated as "good". The reliability domain was most often investigated. Few of the assessment methods in the included studies that had "fair" or "good" measurement property ratings demonstrated acceptable results for both reliability and validity. We found a substantially larger number of clinical scapular assessment methods than previously reported. Using the COSMIN checklist the methodological quality of the included measurement properties in the reliability and validity domains were in general "fair" to "poor". None were examined for all three domains: (1) reliability; (2) validity; and (3) responsiveness. Observational evaluation systems and assessment of scapular upward rotation seem suitably evidence-based for clinical use. Future studies should test and improve the clinimetric properties, and especially diagnostic accuracy and responsiveness, to increase utility for clinical practice.
authors.affiliation: Department of Sports Science and Clinical Biomechanics, University of Southern Denmark , Odense , Denmark .
authors.forename: Camilla Marie
authors.initials: CM
authors.lastname: Larsen
authors.forename: Birgit
authors.initials: B
authors.lastname: Juul-Kristensen
authors.forename: Hans
authors.initials: H
authors.lastname: Lund
authors.forename: Karen
authors.initials: K
authors.lastname: Søgaard
mesh_terms: D001696:Biomechanical Phenomena; D006801:Humans; D009140:Musculoskeletal Diseases / Q000175:diagnosis* / Q000503:physiopathology; D010808:Physical Examination; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012540:Scapula / Q000503:physiopathology*; D012785:Shoulder Joint
keywords: Clinical assessment method; scapular dyskinesis; scapular function; scapular position