title: A biomechanical evaluation of the combined elevation test.
abstract: OBJECTIVE
  To evaluate biomechanically the relationships between the outcome of the Combined Elevation Test, its component joint motions, and thoracic spine angles.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Laboratory.
  
  
  METHODS
  18 elite swimmers and triathletes (11 males and 7 females).
  
  
  METHODS
  Combined Elevation Test outcome in forehead and chin positions. Individual joint contributions to test outcome.
  
  
  RESULTS
  No sex differences were found in test components, or between head positions. Test outcome was greater in the forehead position than the chin position (34.3 cm vs 30.2 cm; p < 0.001). The variables most strongly associated with test outcome were glenohumeral joint flexion (r = 0.86-0.97; p < 0.001), and shoulder retraction (r = 0.75-0.82; p < 0.001). Total thoracic spine angle related strongly to test outcome in females (r = -0.77 to -0.88; p < 0.05), but not in males (r = -0.17 to -0.24; p > 0.05).
  
  
  CONCLUSIONS
  The Combined Elevation Test is an effective screening tool, measuring upper limb mobility into shoulder flexion and scapula retraction in both sexes, and thoracic extension in women. It is recommended that the test be performed in the forehead position. If a subject performs poorly on the test, follow up assessments are required to identify the impairment location.
authors.affiliation: School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, LE11 3TU, UK. Electronic address: s.j.allen@lboro.ac.uk.
authors.forename: Sam
authors.initials: S
authors.lastname: Allen
authors.affiliation: Manchester Medical School, University of Manchester, Oxford Road, Manchester, M13 9PT, UK.
authors.forename: Gemma
authors.initials: G
authors.lastname: Phillips
authors.affiliation: England and Wales Cricket Board National Cricket Performance Centre, Loughborough University, Epinal Way, Loughborough, LE11 3TU, UK.
authors.forename: Steve
authors.initials: S
authors.lastname: McCaig
mesh_terms: D000328:Adult; D056352:Athletes; D001696:Biomechanical Phenomena; D003430:Cross-Sectional Studies; D005260:Female; D006257:Head; D006801:Humans; D008297:Male; D011187:Posture; D016059:Range of Motion, Articular; D012782:Shoulder / Q000502:physiology*; D012785:Shoulder Joint / Q000502:physiology*; D055815:Young Adult
keywords: Shoulder; Swimming; Thoracic spine; Triathlon