Agreement between physiotherapists rating scapular posture in multiple planes in patients with neck pain: Reliability study

Abstract 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. Design Inte...

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Bibliographic Details
Published in:Physiotherapy 2015-12, Vol.101 (4), p.381-388
Main Authors: O’Leary, Shaun, Christensen, Steffan W, Verouhis, Alexis, Pape, Morten, Nilsen, Oivind, McPhail, Steven M
Format: Article
Language:English
Subjects:
Adult
Agreement
Biomechanical Phenomena
Chronic Disease
Female
Humans
Inter-therapist
Kappa
Male
Neck Pain - rehabilitation
Physical Medicine and Rehabilitation
Physical Therapy Modalities - standards
Posture
Reliability
Reproducibility of Results
Scapula - anatomy & histology
Scapular
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Summary:Abstract 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. Design Inter-therapist reliability study. Setting Research laboratory. Participants Fifteen participants with chronic neck pain. Main outcome measures 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.
ISSN:0031-9406
1873-1465
DOI:10.1016/j.physio.2015.01.005