Table of Contents
ISRN Rehabilitation
Volume 2012, Article ID 957389, 8 pages
Research Article

Intratherapist Reliability in the Rating of Scapula Posture in Multiple Planes of Reference

1Centre for Functioning and Health Research, Queensland Health, Cnr of Ipswich Road and Cornwall Street, Brisbane, QLD 4102, Australia
2School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Victoria Park Road, Brisbane, QLD 4059, Australia
3NHMRC Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, University of Queensland, Brisbane, QLD 4072, Australia
4Eggedal Physiotherapy Clinic, Sigdal, 3359 Buskerud, Norway
5Hans & Olaf Physiotherapy Clinic, Torggata 16, 0181 Oslo, Norway
6Norwegian Sports Medicine Clinic (NIMI), 0855 Oslo, Norway
7Medi 3 Clinic, 6003 Alesund, Norway
8University Hospital of Northern Norway, 9019 Tromsø, Norway
9Physiotherapy Department, Royal Brisbane and Women’s Hospital, Herston, Brisbane, QLD 4029, Australia

Received 28 September 2012; Accepted 18 October 2012

Academic Editors: P. Czarnecki and C. B. Swanik

Copyright © 2012 Steven M. McPhail et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Evaluation of scapular posture is a fundamental component in the clinical evaluation of the upper quadrant. This study examined the intrarater reliability of scapular posture ratings. Methods. A test-retest reliability investigation was undertaken with one week between assessment sessions. At each session physical therapists conducted visual assessments of scapula posture (relative to the thorax) in five different scapula postural planes (plane of scapula, sagittal plane, transverse plane, horizontal plane, and vertical plane). These five plane ratings were performed for four different scapular posture perturbating conditions (rest, isometric shoulder; flexion, abduction, and external rotation). Results. A total of 100 complete scapular posture ratings (50 left, 50 right) were undertaken at each assessment. The observed agreement between the test and retest postural plane ratings ranged from 59% to 87%; 16 of the 20 plane-condition combinations exceeded 75% observed agreement. Kappa (and prevalence adjusted bias adjusted kappa) values were inconsistent across the postural planes and perturbating conditions. Conclusions. This investigation generally revealed fair to moderate intrarater reliability in the rating of scapular posture by visual inspection. However, enough disagreement between assessments was present to warrant caution when interpreting perceived changes in scapula position between longitudinal assessments using visual inspection alone.