A Clinical Method for Identifying Scapular Dyskinesis, Part 1: Reliability
A Clinical Method for Identifying Scapular Dyskinesis, Part 1: Reliability
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DOI：
10.4085/1062-6050-44.2.160
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发表时间：
2009-03-01
影响因子：
3.3
通讯作者：
Zlupko, Erica
中科院分区：
文献类型：
--
作者：
McClure, Philip;Tate, Angela R.;Zlupko, Erica
内容：肩关节损伤在高空运动中很常见，肩胛骨运动障碍被认为是这些损伤的一个致病因素。许多作者认为，肩胛骨运动异常，即所谓的运动障碍，与肩关节损伤有关，但关于这种关系的三维测量研究的证据是混合的。可靠和有效的临床方法检测肩胛骨运动障碍是缺乏的。目的：为了确定一个新的测试，旨在检测肩胛骨运动异常的评价者间的可靠性。设计：相关设计使用评级从多对测试。设置：大学体育训练设施。患者或其他参与者：142名运动员（来自国家大学体育协会第一和第三分部）参加需要强烈使用头顶手臂的运动。受试者在进行5次双侧负重（1.4 kg [3 lb]或2.3 kg [5 lb]）肩关节屈曲和额面外展的同时，从后侧进行录像。随后观看来自随机选择的参与者的录像带，并由6名评定者（3对）独立评定肩胛骨运动障碍的存在，每对评定30名不同的参与者。评分员接受培训，以检测肩胛dykinesis使用自我指导的格式与标准化的操作定义和录像的例子，正常和异常motion.Main结果Measure（S）：肩胛dykinesis被定义为存在翼或心律失常。将右侧和左侧独立评定为正常、轻微或明显的运动障碍。结果：符合率在75%~ 82%，kappa（w）在0.48 ~ 0.61之间。结论：肩胛肌运动障碍的检测在肩关节症状风险增加的头顶运动员中具有良好的临床应用价值。
Context: Shoulder injuries are common in athletes involved in overhead sports, and scapular dyskinesis is believed to be one causative factor in these injuries. Many authors assert that abnormal scapular motion, so-called dyskinesis, is related to shoulder injury, but evidence from 3-dimensional measurement studies regarding this relationship is mixed. Reliable and valid clinical methods for detecting scapular dyskinesis are lacking.Objective: To determine the interrater reliability of a new test designed to detect abnormal scapular motion.Design: Correlation design using ratings from multiple pairs of testers.Setting: University athletic training facilities.Patients or Other Participants: A sample of 142 athletes (from National Collegiate Athletic Association Divisions I and III) participating in sports requiring intense overhead arm use.Intervention(s): Participants were videotaped from the posterior aspect while performing 5 repetitions of bilateral, weighted (1.4-kg [3-lb] or 2.3-kg [5-lb]) shoulder flexion and frontal-plane abduction. Videotapes from randomly chosen participants were subsequently viewed and independently rated for the presence of scapular dyskinesis by 6 raters (3 pairs), with each pair rating 30 different participants. Raters were trained to detect scapular dyskinesis using a self-instructional format with standardized operational definitions and videotaped examples of normal and abnormal motion.Main Outcome Measure(s): Scapular dyskinesis was defined as the presence of either winging or dysrhythmia. Right and left sides were rated independently as normal, subtle, or obvious dyskinesis. We calculated percentage of agreement and weighted kappa (kappa(w)) coefficients to determine reliability.Results: Percentage of agreement was between 75% and 82%, and kappa(w) ranged from 0.48 to 0.61.Conclusions: The test for scapular dyskinesis showed satisfactory reliability for clinical use in a sample of overhead athletes known to be at increased risk for shoulder symptoms.