COSMIN database

Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review

Larsen, C. M., Juul-Kristensen, B., Lund, H., and Sogaard, K.
The aims were to compile a schematic overview of clinical scapular assessment methods and critically appraise the methodological quality of the involved studies. A systematic, computer-assisted literature search using Medline, CINAHL, SportDiscus and EMBASE was performed from inception to October 2013. Reference lists in articles were also screened for publications. From 50 articles, 54 method names were identified and categorized into three groups: (1) Static positioning assessment (n = 19); (2) Semi-dynamic (n = 13); and (3) Dynamic functional assessment (n = 22). Fifteen studies were excluded for evaluation due to no/few clinimetric results, leaving 35 studies for evaluation. Graded according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN checklist), the methodological quality in the reliability and validity domains was "fair" (57%) to "poor" (43%), with only one study rated as "good". The reliability domain was most often investigated. Few of the assessment methods in the included studies that had "fair" or "good" measurement property ratings demonstrated acceptable results for both reliability and validity. We found a substantially larger number of clinical scapular assessment methods than previously reported. Using the COSMIN checklist the methodological quality of the included measurement properties in the reliability and validity domains were in general "fair" to "poor". None were examined for all three domains: (1) reliability; (2) validity; and (3) responsiveness. Observational evaluation systems and assessment of scapular upward rotation seem suitably evidence-based for clinical use. Future studies should test and improve the clinimetric properties, and especially diagnostic accuracy and responsiveness, to increase utility for clinical practice.
Physiother Theory Pract
1532-5040 (Electronic)
Publication year:
Functional status:
Physical functioning
Adults (18-65)
Seniors (65+)
Diseases of and symptoms related to the musculoskeletal system and connective tissue
PRO / non-PRO:
Non-patient Reported Outcome
Type of measurement instrument:
4 - Performance-based tests
6 - Clinical rating scales
7 - Observations
Acromial distance
Angular and linear measurements
Classic and modified Qualitative clinical evaluation system
Forward shoulder posture [alias: Baylor/double square]
Initial scapular movement
ISRT - Infraspinatus scapular retraction test
Lower horizontal distance
LSST - Lateral scapular slide tests
MLSST - Modified lateral scapular slide tests
Modified scapular assistance test
MRT - Medial Rotation Test
MSST - Modified scapular slide test
Observational motion analysis
Pectoralis Minor length test
Posterior scapular displacement
Qualitative clinical evaluation system
SAT - Modified Scapular Assistance Test
Scapular abduction [alias: modified DiVeta]
Scapular/glenohumeral rotation
Scapular observation
Scapular protraction and depression
Scapular resting position [alias: the Lennie test]
Scapular stabilizer strength
Scapular upward rotation
Scapular winging during rest
SDT - Scapular dyskinesis test
Static and dynamic scapular positioning and function