COSMIN database

The reliability of physical examination tests for the clinical assessment of scapular dyskinesis in subjects with shoulder complaints: A systematic review

Lange, T., Struyf, F., Schmitt, J., Lutzner, J., and Kopkow, C.
STUDY DESIGN: Systematic review.

OBJECTIVES: The aim of this systematic review was to summarize and evaluate intra- and interrater reliability research of physical examination tests used for the assessment of scapular dyskinesis.

BACKGROUND: Scapular dyskinesis, defined as alteration of normal scapular kinematics, is described as a non-specific response to different shoulder pathologies.

METHODS: A systematic literature search was conducted in MEDLINE, EMBASE, AMED and PEDro until March 20th, 2015. Methodological quality was assessed with the Quality Appraisal of Reliability Studies (QAREL) by two independent reviewers.

RESULTS: The search strategy revealed 3259 articles, of which 15 met the inclusion criteria. These studies evaluated the reliability of 41 test and test variations used for the assessment of scapular dyskinesis.

CONCLUSION: This review identified a lack of high-quality studies evaluating intra- as well as interrater reliability of tests used for the assessment of scapular dyskinesis. In addition, reliability measures differed between included studies hindering proper cross-study comparisons. The effect of manual correction of the scapula on shoulder symptoms was evaluated in only one study, which is striking, since symptom alteration tests are used in routine care to guide further treatment. Thus, there is a strong need for further research in this area.

LEVEL OF EVIDENCE: Diagnosis, level 3a.
Phys Ther Sport
Publication year:
Biological and physiological variables:
Biological and physiological variables
Symptom status:
Physical state
Adults (18-65)
Diseases of and symptoms related to the musculoskeletal system and connective tissue
PRO / non-PRO:
Non-patient Reported Outcome
Type of measurement instrument:
6 - Clinical rating scales
7 - Observations
Angular and linear measurements
Angular scapular measurements (versions: tilt; rotation)
Clavicular movement during the first 60 degrees of flexion
LSST - Lateral scapular slide tests (versions: mLSST; inferior LSST; superior LSST)
Measurement of scapular positioning
Medial scapular border to T4
Movement of the cervicothoracic junction during the last phase of flexion
Observational classification 4-type method
Pectoralis Minor length test
SAT - Scapular Assistance Test (versions: mSAT - Modified SAT)
Scapular winging (during rest or various movements)
Scapula upward rotation
Static Alignment
Static and dynamic scapular positioning and function