title: Comprehensive classification test of scapular dyskinesis: A reliability study.
abstract: BACKGROUND
  Assessment of scapular dyskinesis (SD) is of clinical interest, as SD is believed to be related to shoulder pathology. However, no clinical assessment with sufficient reliability to identify SD and provide treatment strategies is available.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the reliability of the comprehensive SD classification method.
  
  
  METHODS
  Cross-sectional reliability study.
  
  
  METHODS
  Sixty subjects with unilateral shoulder pain were evaluated by two independent physiotherapists with a visual-based palpation method. SD was classified as single abnormal scapular pattern [inferior angle (pattern I), medial border (pattern II), superior border of scapula prominence or abnormal scapulohumeral rhythm (pattern III)], a mixture of the above abnormal scapular patterns, or normal pattern (pattern IV). The assessment of SD was evaluated as subjects performed bilateral arm raising/lowering movements with a weighted load in the scapular plane. Percentage of agreement and kappa coefficients were calculated to determine reliability.
  
  
  RESULTS
  Agreement between the 2 independent physiotherapists was 83% (50/60, 6 subjects as pattern III and 44 subjects as pattern IV) in the raising phase and 68% (41/60, 5 subjects as pattern I, 12 subjects as pattern II, 12 subjects as pattern IV, 12 subjects as mixed patterns I and II) in the lowering phase. The kappa coefficients were 0.49-0.64.
  
  
  CONCLUSIONS
  We concluded that the visual-based palpation classification method for SD had moderate to substantial inter-rater reliability. The appearance of different types of SD was more pronounced in the lowering phase than in the raising phase of arm movements.
authors.affiliation: School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taiwan, ROC.
authors.forename: Tsun-Shun
authors.initials: TS
authors.lastname: Huang
authors.affiliation: School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taiwan, ROC.
authors.forename: Han-Yi
authors.initials: HY
authors.lastname: Huang
authors.affiliation: Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taiwan, ROC.
authors.forename: Tyng-Guey
authors.initials: TG
authors.lastname: Wang
authors.affiliation: Graduate Institute of Sports Equipment Technology, University of Taipei, Taiwan, ROC.
authors.forename: Yung-Shen
authors.initials: YS
authors.lastname: Tsai
authors.affiliation: School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taiwan, ROC. Electronic address: jiujlin@ntu.edu.tw.
authors.forename: Jiu-Jenq
authors.initials: JJ
authors.lastname: Lin
mesh_terms: D003430:Cross-Sectional Studies; D020820:Dyskinesias / Q000145:classification* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D010173:Palpation / Q000379:methods*; D010808:Physical Examination / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology*; D015203:Reproducibility of Results; D012540:Scapula / Q000503:physiopathology*; D012680:Sensitivity and Specificity; D012785:Shoulder Joint / Q000503:physiopathology*; D055815:Young Adult
keywords: Classification; Reliability; Scapular dyskinesis