title: The reliability of physical examination tests for the clinical assessment of scapular dyskinesis in subjects with shoulder complaints: A systematic review.
abstract: METHODS
  Systematic review.
  
  
  OBJECTIVE
  The aim of this systematic review was to summarize and evaluate intra- and interrater reliability research of physical examination tests used for the assessment of scapular dyskinesis.
  
  
  BACKGROUND
  Scapular dyskinesis, defined as alteration of normal scapular kinematics, is described as a non-specific response to different shoulder pathologies.
  
  
  METHODS
  A systematic literature search was conducted in MEDLINE, EMBASE, AMED and PEDro until March 20th, 2015. Methodological quality was assessed with the Quality Appraisal of Reliability Studies (QAREL) by two independent reviewers.
  
  
  RESULTS
  The search strategy revealed 3259 articles, of which 15 met the inclusion criteria. These studies evaluated the reliability of 41 test and test variations used for the assessment of scapular dyskinesis.
  
  
  CONCLUSIONS
  This review identified a lack of high-quality studies evaluating intra- as well as interrater reliability of tests used for the assessment of scapular dyskinesis. In addition, reliability measures differed between included studies hindering proper cross-study comparisons. The effect of manual correction of the scapula on shoulder symptoms was evaluated in only one study, which is striking, since symptom alteration tests are used in routine care to guide further treatment. Thus, there is a strong need for further research in this area.
  
  
  METHODS
  Diagnosis, level 3a.
authors.affiliation: University Hospital Carl Gustav Carus Dresden, Center for Evidence-Based Healthcare, Fetscherstr. 74, 01307 Dresden, Germany.
authors.forename: Toni
authors.initials: T
authors.lastname: Lange
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium.
authors.forename: Filip
authors.initials: F
authors.lastname: Struyf
authors.affiliation: University Hospital Carl Gustav Carus Dresden, Center for Evidence-Based Healthcare, Fetscherstr. 74, 01307 Dresden, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Schmitt
authors.affiliation: University Hospital Carl Gustav Carus Dresden, Department of Orthopaedic and Trauma Surgery, Fetscherstr. 74, 01307 Dresden, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Lützner
authors.affiliation: University Hospital Carl Gustav Carus Dresden, Department of Orthopaedic and Trauma Surgery, Fetscherstr. 74, 01307 Dresden, Germany; Hochschule für Gesundheit (University of Applied Sciences), Department of Applied Health Sciences, Gesundheitscampus 6-8, D-44801 Bochum, Germany. Electronic address: christian.kopkow@hs-gesundheit.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Kopkow
mesh_terms: D001696:Biomechanical Phenomena; D020820:Dyskinesias / Q000175:diagnosis*; D006801:Humans; D010808:Physical Examination / Q000379:methods*; D015203:Reproducibility of Results; D012540:Scapula / Q000503:physiopathology*; D012785:Shoulder Joint / Q000503:physiopathology*
keywords: Diagnosis; Literature search; QAREL; Symptom alteration tests