Shoulder proprioception: How is it measured and is it reliable? A systematic review

• Published in: Journal of hand therapy 2017-04, Vol.30 (2), p.221-231
• Main Authors: Ager, Amanda L., MSc, PT, Roy, Jean-Sébastien, PT, PhD, Roos, Marianne, M.Mus, Belley, Amélie Fournier, MSc, Cools, Ann, PT, PhD, Hébert, Luc J., PT, PhD
• Format: Article
• Language: English
• Subjects: Correlation analysis; Correlation coefficients; Disorders; Humans; Joint position sense; Joint surgery; Kinesthesia; Limbs; Literature reviews; Measurement techniques; Motion detection; Movement; Musculoskeletal diseases; Physical Medicine and Rehabilitation; Proprioception; Proprioception - physiology; Psychometric properties; Psychometrics; Quantitative psychology; Range of Motion, Articular; Rehabilitation; Reliability; Reproducibility of Results; Reviews; Shoulder; Shoulder Joint - physiology; Studies; Systematic review; Validity
• ISSN: 0894-1130; 1545-004X
• DOI: 10.1016/j.jht.2017.05.003

Abstract Study Design Systematic review. Introduction Constituents of proprioception include our awareness of the position (joint position sense [JPS]) and motion (kinesthesia) of our limbs in space. Proprioceptive deficits are associated with musculoskeletal disorders but remain a challenge to quantify, particularly at the shoulder. Purpose of the Study To report the psychometric values of validity, reliability, and responsiveness for shoulder JPS and/or kinesthesia protocols. Methods A review of 5 databases was conducted from inception to July 2016 for studies reporting a psychometric property of a shoulder proprioception protocol. The included studies were evaluated using the QualSyst checklist and COSMIN 4-point scale. Results Twenty-one studies were included, yielding 407 participants and 553 evaluated shoulders (n). The included studies support excellent methodological scores using the QualSyst checklist (88.1 ± 9.9%) and good psychometric scores with the COSMIN for reliability (71.1%) and moderate-to-low quality score (50%) for criterion validity. Weighted average intraclass correlation coefficients (ICCs) for intrarater reliability were highest for passive JPS and kinesthesia, ICC = 0.92 ± 0.07 ( n = 214) and ICC = 0.92 ± 0.04 ( n = 74), respectively. The most reliable movement and tool are internal rotation at 90° of abduction, ICC = 0.88 ± 0.01 ( n = 53), and the dynamometer, ICC = 0.92 ± 0.88 ( n = 225). Only 2 studies quantify an aspect of validity and no responsiveness indices were reported among the included studies. Conclusion Based on the results of the included studies, the evaluation of shoulder proprioception is most reliable when using a passive protocol with an isokinetic dynamometer for internal rotation at 90° of shoulder abduction. Standardized protocols addressing the psychometric properties of shoulder proprioception measures are needed. Level of Evidence Level 1a: systematic review.