Agreement between physiotherapists rating scapular posture in multiple planes in patients with neck pain: Reliability study.
OBJECTIVE
Evaluation of scapular posture is an integral component of the clinical assessment of painful neck disorders. The aim of this study was to evaluate agreement between therapist judgements of scapula posture in multiple biomechanical planes in individuals with neck pain.


METHODS
Inter-therapist reliability study.


METHODS
Research laboratory.


METHODS
Fifteen participants with chronic neck pain.


METHODS
Four physiotherapists recorded ratings of scapular orientation (relative to the thorax) in five different scapula postural planes (plane of scapula, sagittal plane, transverse plane, horizontal plane, and vertical plane) under four test conditions (at rest, and during three isometric shoulder conditions) in all participants. Inter-therapist reliability was expressed using both generalized and paired kappa coefficient.


RESULTS
Following adjustment for expected agreement and the high prevalence of neutral ratings (81%), on average both the generalised kappa (0.37) as well as Cohen's Kappa for the two therapist pairs (0.45 and 0.42) demonstrated only slight to moderate inter-therapist reliability.


CONCLUSIONS
The findings suggest that ratings of scapular posture in individuals with neck pain by visual inspection has only slight to moderate reliability and should only be used in conjunction with other clinical tests when judging scapula function in these patients.
NHMRC Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, University of Queensland, Brisbane 4072, QLD, Australia; Physiotherapy Department, Royal Brisbane and Women's Hospital, Queensland Health, Herston, Brisbane 4029, QLD, Australia. Electronic address: s.oleary@uq.edu.au.
Shaun
S
O'Leary
NHMRC Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, University of Queensland, Brisbane 4072, QLD, Australia; Laboratory for Musculoskeletal Pain and Motor Control, Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, 9220 Aalborg East, Denmark. Electronic address: stc@hst.aau.dk.
Steffan W
SW
Christensen
NHMRC Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, University of Queensland, Brisbane 4072, QLD, Australia; Rehabtjänst, St: Eriksgatan 48, 112 34 Stockholm, Sweden. Electronic address: alexis.verouhis@rehabtjanst.se.
Alexis
A
Verouhis
NHMRC Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, University of Queensland, Brisbane 4072, QLD, Australia; Odense Fysioterapi, Idrætsklinik & Fitness, Vestre Stationsvej 11, 5000 Odense C, Denmark. Electronic address: morten@haugaardpape.dk.
Morten
M
Pape
NHMRC Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, University of Queensland, Brisbane 4072, QLD, Australia; Kringsjå-Sogn Fysioterapi, Folke Bernadottesvei 41, 0862 Oslo, Norway. Electronic address: oivindnilsen@gmail.com.
Oivind
O
Nilsen
Centre for Functioning and Health Research, Metro South Health, Cnr of Ipswich Road and Cornwall Street, Brisbane 4102, QLD, Australia; School of Public Health & Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Victoria Park Road, Brisbane 4059, QLD, Australia. Electronic address: steven.mcphail@qut.edu.au.
Steven M
SM
McPhail
D000328:Adult; D001696:Biomechanical Phenomena; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D019547:Neck Pain / Q000534:rehabilitation*; D026741:Physical Therapy Modalities / Q000592:standards*; D011187:Posture; D015203:Reproducibility of Results; D012540:Scapula / Q000033:anatomy & histology*
Agreement; Inter-therapist; Kappa; Posture; Reliability; Scapular