Reliability, agreement, and diagnostic accuracy of the Modified Lateral Scapular Slide test.
BACKGROUND
The Lateral Scapular Slide Test is a static test used in clinical settings to assess medio-lateral inferior angle displacement and scapular asymmetry at three different degrees of shoulder abduction. However, there is no evidence in the literature about the reliability and diagnostic accuracy of a modified LSST (arm elevation in the scapular plane with loading) in a symptomatic population.


OBJECTIVE
To assess the intra- and inter-rater reliability, agreement, and diagnostic accuracy of the MLSST ​ (Modified Lateral Scapular Slide Test) in subjects with and without shoulder symptoms. A new test position is examined, in which the arm is held in 90° of elevation in the scapular plane with 1 kg load.


METHODS
Within day intra- and inter-rater reliability, agreement, and diagnostic accuracy study.


METHODS
Participants included 25 (42 ± 2.7 years) subjects with shoulder symptoms and 25 (40 ± 2.1 years) asymptomatic control subjects. Two raters, blinded to each other's outcomes, measured the distance between the inferior scapular angle and T7 at arms by the side, hands on hips and 90° of arm elevation in the scapular plane with 1 kg load. Measurements were performed twice, bilaterally. Intraclass correlation coefficient (ICC), minimal detectable change (MDC95%) and diagnostic accuracy were calculated.


RESULTS
The ICCs for intra- and inter-rater reliability were good to high in both shoulders of symptomatic and asymptomatic groups. The MDC95% in the symptomatic group ranged between 0.67 and 1.40 cm in the symptomatic shoulder and 0.72-1.16 cm in the asymptomatic shoulder. The asymptomatic group presented a MDC95% ranging between 0.63 and 1.52 cm in the dominant and 0.60-1.41 cm in the non dominant shoulder. Positive and negative likelihood ratios ranged between 0.67-5.50 and 0.81-1.11, respectively.


CONCLUSIONS
The MLSST had good reliability and agreement properties to assess scapular position in both groups. However, no test position had clinical utility as a diagnostic criterion for shoulder pathology.
Department of Physiotherapy, School of Rehabilitation Tehran University of Medical Sciences, (TUMS), Tehran, Iran.
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Shadmehr
Department of Physiotherapy, School of Rehabilitation, International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran. Electronic address: hsarafraz@razi.tums.ac.ir.
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Sarafraz
Iranian Red Crescent Society (IRCS), Rehabilitation Center, Bandarabbas, Iran.
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Heidari Blooki
Biostatistics, Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, (TUMS), Tehran, Iran.
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Jalaie
Polytechnic Institute of Leiria, School of Health Sciences (ESSLei), Campus 2 - Morro Do Lena - Alto Do Vieiro, 2411-901 Leiria, Portugal.
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Morais
D000328:Adult; D000886:Anthropometry / Q000379:methods; D001696:Biomechanical Phenomena / Q000502:physiology*; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis*; D008297:Male; D016059:Range of Motion, Articular / Q000502:physiology*; D015203:Reproducibility of Results; D012540:Scapula / Q000293:injuries* / Q000503:physiopathology*; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology*
Diagnostic accuracy; Lateral scapular slide test; Reliability; Scapular asymmetry; Scapular position