Qualitative clinical evaluation of scapular dysfunction: a reliability study

The purpose of this study was to determine the intrarater and interrater reliability of a clinical evaluation system for scapular dysfunction. No commonly accepted terminology presently exists for describing the abnormal dynamic scapular movement patterns that are commonly associated with shoulder injury. A method of observation was devised for clinical evaluation of scapular dysfunction. Blinded evaluators (2 physicians and 2 physical therapists) were familiarized with the evaluation method of scapular movement patterns before viewing a videotape of 26 subjects with and without scapular dysfunction. Each evaluator was asked to categorize the predominant scapular movement pattern observed during bilateral humeral scaption and abduction motions. Reliability was assessed by a kappa Coefficient. Intertester reliability (kappa=0.4) was found to be slightly lower than intratester reliability (kappa=0.5). These results indicate that, with refinement, this qualitative evaluation method may allow clinicians to standardize the categorization of dynamic scapular dysfunction patterns.