Are clinical scapular measurements reliable and can they differentiate between stroke patients?

Abstract

Background: The scapula plays an important role in stabilizing and supporting the arm during shoulder movement and preventing injury of soft tissues. Currently, scapular kinematics are measured in stroke patients using expensive 3D electromagnetic tracking devices. This study investigates the intra-and inter-session reliability and discriminant ability of affordable clinical methods to measure scapular movement in stroke patients. Methods: Scapular kinematics were measured in 40 stroke patients (28 men, 12 women). The measurement protocol consisted of (1) Pectoralis Minor index; (2) Scapular distance test; (3) Scapular lateral rotation by means of inclinometry; (4) Measurement of forward shoulder posture with the acromial distance test; (5) Dynamic control of translation and tilting during the kinetic medial rotation test; (6) Full humeral elevation. Stroke patients were divided into subgroups based on 2 variables: firstly, based on their full humeral elevation (less than 120°, 120-149°, more than 149°); secondly, based on the phases of stroke (subacute, chronic). Differences between these subgroups were assessed using Kruskal Wallis analysis and Mann-whitney post-hoc tests. The intra- and inter-session reliability of obtained parameters were calculated in 8 patients with intraclass correlation coefficient (ICC) and standard error of measurement (SEM). Results: Intra- and inter-session reliability of all clinical methods were moderately high to very high, (range 0.77 and 0.99). For the groups' variable full humeral elevati