Journal of Athletic Training 2021;56(6):586–593

doi: 10.4085/276-20
Ó by the National Athletic Trainers’ Association, Inc Shoulder
www.natajournals.org

Reliability and Validity of a Clinical Assessment Tool

for Measuring Scapular Motion in All 3 Anatomical
Planes
Oliver A. Silverson, MS, ATC*; Nicole G. Lemaster, PhD, ATC, CES*;
Carolyn M. Hettrich, MD, MPH†; Nicholas R. Heebner, PhD, ATC*;

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Tim L. Uhl, PhD, ATC, PT*
*College of Health Sciences, University of Kentucky, Lexington; †Shoulder Service, Brigham and Women’s Hospital,
Boston, MA

Context: A single clinical assessment device that can be and excursion during each condition. Both the intrarater reliability
used to objectively measure scapular motion in each anatomical between testing sessions and the interrater reliability recorded in
plane is not currently available. The development of a novel the same session were assessed using intraclass correlation
electric goniometer would allow scapular motion in all 3 coefficients (ICCs [2,3]). The criterion validity was examined by
anatomical planes to be quantified. comparing the mean excursion values of each condition recorded
Objective: To investigate the reliability and validity of an using the electric goniometer and the 3-dimensional optical
electric goniometer for measuring scapular motion in each motion-capture system. Validity was assessed by evaluating the
anatomical plane during upper extremity elevation. average difference and root mean square error.
Design: Cross-sectional study. Results: The between-sessions intrarater reliability was
Setting: Laboratory. moderate to good (ICC [2,3] range ¼ 0.628–0.874). The within-
Patients or Other Participants: Sixty participants (29 session interrater reliability was moderate to excellent (ICC [2,3]
women, 31 men; age ¼ 30 6 14 years, height ¼ 1.73 6 0.10 m, range ¼ 0.545–0.912). The average difference between total
mass ¼ 75.32 6 16.90 kg) recruited from the general population. excursion values recorded using the electric goniometer and the
Intervention(s): An electric goniometer was used to record 3-dimensional optical motion-capture system ranged from 78 to
clinical measurements of scapular position at rest and total arc 48, and the root mean square error ranged from 78 to 108.
of motion (excursion) during active upper extremity elevation in 2
Conclusions: The reliability of scapular measurements was
testing sessions separated by several days. Measurements
best when a standard operating procedure was used. The
were recorded independently by 2 examiners. In 1 session,
electric goniometer provided an accurate measurement of
scapular motion was recorded simultaneously using a 14-
camera, 3-dimensional optical motion-capture system. scapular excursions in all 3 anatomical planes during upper
Main Outcome Measure(s): Reliability analysis included extremity elevation.
examination of clinical measurements for scapular position at rest Key Words: psychometric values, upper extremity, shoulder

Key Points
 The electric goniometer provided clinicians and researchers with a simple tool for objectively measuring scapular
position and motion in all 3 anatomical planes.
 The electric goniometer demonstrated moderate to excellent intrarater and interrater reliability for measuring
scapular position at rest and total excursion within and between testing sessions.
 The device was valid for measuring scapular motion in the transverse plane.

M
otion of the shoulder complex consists of a quantify scapular motion. Currently, the criterion standard
combination of movements from the glenohu- for evaluating multiplanar scapular motion includes the use
meral, acromioclavicular, and sternoclavicular of bone pins, radiography, and magnetic resonance
joints, as well as the scapulothoracic articulation.1,2 The imaging.2,7–9 Noninvasive reference standards for tracking
scapula moves in multiple anatomical planes during scapular kinematics, such as video-based 3-dimensional
humeral motion and is integral to optimal function of the (3D) motion analysis and 3D electromagnetic tracking,
upper extremity.1–3 Alterations in scapular motion have have been validated using the criterion standard meth-
been attributed to pathologic conditions, such as multidi- ods.8,10 Although they accurately measure scapular motion,
rectional instability, impingement, nerve palsies, rotator these techniques have their drawbacks, such as their lack of
cuff tears, and biceps tendinopathy.4–6 availability to clinicians, invasive nature, complex compu-
To understand how scapular motion contributes to upper tations required, expense, and restriction to a laboratory
extremity function, clinicians must be able to accurately setting.

586 Volume 56  Number 6  June 2021

 To overcome these limitations of laboratory-based motion-capture system, and we proposed that the intrarater
methods, assessment techniques are needed to measure reliability of each examiner between the 2 test days would
scapular motion in the clinical setting. Furthermore, reliable exceed an ICC value of 0.80, whereas the interrater
and precise objective scapular measurement can guide reliability between the examiners on a single day of testing
treatment plans and rehabilitation efforts for upper would exceed an ICC value of 0.70. Establishing the
extremity pathologic conditions. The objective assessment reliability and validity characteristics of the electric
of scapular motion has been examined in previous goniometer will provide critical evidence regarding the
literature.11–13 Both observational and palpation-based utility of these IMU-based devices for measuring scapular
techniques have been evaluated; however, the observational motion. If reliable and valid, these types of devices will
approach lacks objective measurement values, rendering enable clinicians to objectively measure scapular motion in
the method a subjective screening tool.11 The gravity- the clinical setting.
referenced digital inclinometer, first investigated by
Johnson et al,12 has demonstrated good to excellent METHODS
intrarater reliability (intraclass correlation coefficient
[ICC] [3,1] range ¼ 0.89–0.96) and moderate to good Participants

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validity (r range ¼ 0.59–0.73) for measuring the scapular A convenience sample generated a total of 67 inquiries
motions of upward and downward rotation in the frontal from the general population in Lexington, Kentucky. All
plane during upper extremity elevation. Subsequently, volunteers were screened for eligibility based on the
Scibek and Carcia13 further investigated the gravity- following inclusion criteria: age between 18 and 99 years,
referenced digital inclinometer for measuring the scapular willingness to attend 2 testing sessions separated by at least
motions of anterior and posterior tilt in the sagittal plane 24 hours, the ability to lift the right upper extremity to at
during upper extremity elevation and reported excellent least 1208 in the scapular plane, and no self-reported medical
intrarater reliability (ICC [3,1] range ¼ 0.97–0.99) and restrictions relating to the upper extremity or spine at the
moderate to good validity (r range = 0.63–0.86). These time of the study. An a priori power analysis conducted
findings, supported by subsequent studies,12–17 demonstrat- using nQuery software (version 8.1; Statistical Solutions Ltd)
ed that gravity-referenced digital inclinometers were indicated a sample size of 60 participants would have 90%
reliable and valid for measuring scapular motion in the power to detect a difference in means of 38 in scapular
frontal and sagittal planes. motion and minimize the chance of type II error.
Whereas a digital inclinometer is a noninvasive, portable We identified and enrolled 60 participants (29 women, 31
clinical assessment tool for objectively measuring scapular men; age ¼ 30 6 14 years, height ¼ 1.73 6 0.10 m, mass ¼
motion in the frontal and sagittal planes, it is not capable of 75.32 6 16.90 kg) who met the inclusion criteria. All
measuring the scapular motions of internal and external participants completed 2 testing sessions, with an average
rotation in the transverse plane because of its reliance on time between sessions of 9 days. All participants provided
gravity-referenced sensors. However, new advances in the written informed consent, and the study protocol was
development of a novel electric goniometer, equipped with an approved by the University of Kentucky Institutional
inertial measurement unit (IMU), allow clinical measure- Review Board (No. 43537).
ments of scapular motion in the transverse plane. Like the
angular rotation recorded by the accelerometer in the gravity- Instrumentation
referenced inclinometer, the IMU captures angular rotations
relative to a reference position created and stored using a The EasyAngle electric goniometer (Meloq AB) was
triaxial gyroscope and magnetometer. The 2 additional used to perform clinical measurements of scapular motion
sensors enable the system to calculate angular rotations (Figure 1). Before data collection, an upright polyvinyl
relative to any defined calibration position, which does not chloride (PVC) pole was placed at 308 anterior to the
have to be in the line of gravity, thereby overcoming the frontal plane relative to the participant’s sitting location,
limitations of gravity-referenced inclinometers. marking the scapular plane. Participants were instructed to
Currently, easily and accurately quantifying scapular actively raise the upper extremity with the wrist touching
motion in all 3 anatomical planes using a single clinical the PVC pole until they reached 1208, as confirmed using a
device is not possible. Although a new electric goniometer standard goniometer. When the individual reached 1208 of
equipped with an IMU can overcome this limitation, we do upper extremity elevation, a quick-grip mini bar clamp
not know if this novel device is reliable or valid for (Irwin Tools) was used to mark and physically limit 1208 of
measuring scapular motion in each anatomical plane. upper extremity elevation on the PVC pole (Figure 2). An I-
Therefore, the purpose of our study was to investigate the beam square bubble level (model 7724; Johnson Level &
reliability and validity of an IMU-based electric goniometer Tool Manufacturing Co, Inc) was used to calibrate the
for measuring scapular motion during upper extremity electric goniometer for measurements taken in the sagittal
elevation. To determine the intrarater and interrater plane as described.
reliability, we examined the reliability characteristics of Three-dimensional motion capture was recorded using a
measurements across days and between examiners. We also Nexus (Vicon Motion Systems Ltd) 14-camera, high-
sought to establish criterion validity by comparing the speed, infrared, video-based, optical, motion-capture
measurements recorded using the electric goniometer and a system. Raw marker trajectory data were stored and
validated reference standard of 3D optical motion capture. reconstructed using Nexus software (version 2.9; Vicon
We hypothesized that the measurements recorded using the Motion Systems Ltd). Reconstructed kinematic data were
electric goniometer would not exceed 108 of error exported and analyzed using Visual3D (version 9
compared with those recorded using the 3D optical Professional; C-Motion, Inc).

Journal of Athletic Training 587

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Figure 1. A, Identification of one-third of the distance between the root of the scapular spine and the posterior acromial angle. Orientation
of the electric goniometer (EasyAngle; Meloq AB) for measuring scapular motion in the B, frontal plane; C, transverse plane; and D, sagittal
plane, with inset illustrating calibration in the sagittal plane.

Procedures sagittal planes. To facilitate consistency of the clinical

measurements between examiners and to accommodate the
The clinical measurements using the electric goniometer placement of the retroreflective markers used for 3D optical
were recorded independently by each examiner during motion capture, a standard operating procedure was
upper extremity elevation in the frontal, transverse, and implemented. For each anatomical plane, the calibration

588 Volume 56  Number 6  June 2021

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Figure 2. Measurement of scapular motion in the frontal plane Figure 3. Standardized marker setup for 3-dimensional optical
during upper extremity elevation to 1208 in the scapular plane. motion capture. The scapular and thorax joint coordinate system is
shown with positive motion in the direction of the arrows.

technique and specific location for the electric goniometer

based on several scapular landmarks followed a standard final scapular position (end) after motion was completed.
procedure. To measure scapular motion in the frontal plane, Three trials of active upper extremity elevation were
we calibrated the electric goniometer to the floor directly recorded for each scapular condition, totaling 9 trials for
beneath participants to represent 08. The electric goniom- data collection. Constant pressure and contact were main-
eter was placed on the scapular spine at one-third of the tained with the scapular landmark during each movement.
distance between the root of the scapular spine and the The order of anatomical planes was randomized before
posterior acromial angle, as measured and marked using a testing, and the same order was used on both test days.
cloth tape measure (Figure 1A), and oriented posteriorly Clinical measurements of scapular motion were interpreted
(Figure 1B). To measure scapular motion in the transverse following the guidelines of the International Society of
plane, the electric goniometer was calibrated using a Biomechanics18: positive scapular motion in the frontal,
perpendicular edge of a floor tile beneath participants to transverse, and sagittal planes is identified as downward
represent 08. The electric goniometer was placed at the rotation, internal rotation, and posterior tilt, respectively.
same location on the scapular spine as described for frontal- On 1 day of testing, 3D optical motion capture was
plane motion but oriented superiorly (Figure 1C). To record recorded simultaneously with the clinical measurements.
scapular motion in the sagittal plane, we calibrated the Surface reflective markers were attached to the participant
electric goniometer to the vertical I-beam square level to using 2-sided tape following the procedures outlined by
represent 08, placed on the most prominent portion of the Chu et al8 in a validation study of the marker-based motion-
medial scapular border and oriented laterally (Figure 1D). capture model of scapular motion (Figure 3). A scapular
All participants began each trial seated in an upright acromial marker cluster (AMC) was created using a rigid
position on a 35-cm-tall stool with their feet flat on the floor. triangular body and was applied to the posterior acromial
The motion of upper extremity elevation was explained and process and medial to the posterior acromial calibration
demonstrated. They were able to practice the motion several marker (Figure 1B). Recording of scapular motion using an
times and ask questions before data collection. To begin each AMC has shown excellent within-session reliability (ICC
trial, the examiner applied the electric goniometer to the range ¼ 0.90–0.98) and a standard error of measurement
specified scapular landmark and instructed the participant to (SEM) of 2.258 for active upper extremity elevation,
assume an upright and relaxed sitting posture. The scapular protraction, and retraction and has been validated against
rest position was recorded, and then the participant was criterion standard techniques, such as dynamic radiogra-
prompted to perform the desired condition. After completing phy.8,19 The raw kinematic camera data were collected at
active movement, the individual held the final position for 200 Hz and smoothed using a low-pass Butterworth filter
several seconds while the examiner measured the end with a cutoff frequency of 6 Hz. Joint coordinate systems
scapular position. Total excursion values were calculated and segment parameters for the trunk, pelvis, and scapula
by subtracting the initial scapular position (rest) from the were oriented with the x axis pointed anteriorly, the y axis

Journal of Athletic Training 589

Table 1. Intrarater Reliability Results of a Single Rater Between 2 Testing Sessions
Day, 8 (Mean 6 SD) Intraclass Standard
Scapular Anatomical Correlation Error of Minimal Detectable
Measure Plane 1 2 Coefficient (2,3) Measure, 8 Change at 90% CI, 8
Rest position Frontala 3 6 6 2 6 5 0.692 3 7
Transverseb 30 6 7 30 6 7 0.805 3 7
Sagittalc 26 6 7 28 6 7 0.874 3 6
Total excursion Frontala 19 6 7 19 6 6 0.701 4 9
Transverseb 5 6 4 5 6 3 0.628 2 5
Sagittalc 18 6 6 20 6 6 0.790 3 7
a
Positive values indicated downward rotation.
b
Positive values indicated internal rotation.
c
Positive values indicated posterior tilt.

oriented superiorly, and the z axis oriented laterally (Figure RESULTS

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3).18 A Euler rotation sequence for scapular motion in the
Reliability
frontal and transverse planes was resolved as Y, X, Z and
calculated relative to the thorax per the guidelines of the We observed moderate to good intrarater reliability for
International Society of Biomechanics.18 determining the scapular rest position and scapular
excursion between testing sessions (Table 1). Interrater
Statistical Analysis reliability was good to excellent for measuring the scapular
rest position and moderate for measuring the scapular
We applied a test-retest design to examine the intrarater excursion during a testing session (Table 2).
reliability of each examiner between testing sessions and
the interrater reliability of both examiners in the same Validity
testing session for clinical measurements recorded using the
electric goniometer. Both the intrarater and interrater The validity results are presented in Table 3. Bland-
reliability of scapular measurements recorded during rest Altman plots are provided in Supplemental Figures 1
and excursion for each anatomical plane were assessed via through 3. We found differences between the mean
ICC (2,3) using the average of 3 trials of motion. We scapular excursions recorded using the electric goniometer
interpreted the ICCs as poor (,0.5), moderate (0.5–0.75), and 3D optical motion-capture system for the frontal (P ,
good (0.76–0.90), or excellent (.0.90) reliability.20 Mea- .001), transverse (P ¼ .015), and sagittal (P , .001) planes.
surement precision was determined by calculating the SEM The RMSE ranged from 78 to 108, and the average
and the minimal detectable change score at the 90% CI.21 difference ranged from 78 to 48.
The criterion validity of the electric goniometer versus
the reference standard of the 3D optical motion-capture DISCUSSION
system for measuring total scapular excursion in each We investigated the reliability and validity of a novel
anatomical plane was determined using several approaches. electric goniometer for measuring scapular motion in each
First, a paired t test was used to compare the average anatomical plane during upper extremity elevation. The
excursion of 3 trials of motion between the electric intrarater and interrater reliability of the clinical scapular
goniometer and the 3D optical motion-capture system. measurements was investigated across days and between
We set the a level a priori at .05, although a Bonferroni examiners and addressed the criterion validity of measure-
correction was applied to account for the 3 comparisons of ments recorded using the clinical assessment device
each condition in each plane. This correction reduced the a compared with the reference standard of 3D optical motion
level to .017. Second, the root mean square error (RMSE) capture. Our results indicated that the electric goniometer
was calculated to determine the error associated with the was a reliable device for measuring the scapular rest
electric goniometer versus the 3D optical motion-capture position and total excursion in each anatomical plane when
system for each condition. Third, we created Bland-Altman a standard operating procedure was used. Furthermore, the
plots to examine the average difference and limits of electric goniometer had moderate validity for measuring
agreement (LOAs) between the electric goniometer and 3D scapular excursions in all 3 anatomical planes in a clinical
optical motion-capture system. The LOAs were calculated setting.
by multiplying the SD of the average difference by 1.96 to Before data collection, we hypothesized that the
observe the 95% CIs.22 Validity was determined by measurements recorded using the electric goniometer
observing the RMSE values: ,58 indicated strong, 58 to would not exceed 108 of error compared with those
108 indicated moderate, and .108 indicated poor validi- recorded using the 3D optical motion-capture system.
ty.8,23 Analysis of the Bland-Altman plots revealed a Although the resultant P values demonstrated differences
systematic average difference of 78 between scapular among mean values for scapular excursion in each
excursions recorded using the electric goniometer and the anatomical plane, the comparison of means alone was not
3D optical motion-capture system for scapular motion sufficient for a complete validity analysis.24 Therefore, we
measured in the frontal plane. Therefore, a correction factor used a multistep approach to assess validity using statistics,
of þ78 was applied to the clinical data for mean scapular such as RMSE, average difference, and LOA.22 The
excursion in the frontal plane. threshold of RMSE was rooted in the notion that 108 of

590 Volume 56  Number 6  June 2021

Table 2. Interrater Reliability Between 2 Raters in a Single Testing Session
Rater, 8 (Mean 6 SD) Intraclass Standard
Scapular Anatomical Correlation Error of Minimal Detectable
Measure Plane 1 2 Coefficient (2,3) Measure, 8 Change at 90% CI, 8
Rest position Frontala 1 6 5 2 6 5 0.833 3 8
Transverseb 30 6 7 30 6 7 0.912 4 9
Sagittalc 24 6 6 28 6 7 0.841 3 7
Total excursion Frontala 22 6 7 19 6 6 0.724 4 9
Transverseb 6 6 4 5 6 3 0.545 4 8
Sagittalc 19 6 6 20 6 6 0.703 5 11
a
Positive values indicated downward rotation.
b
Positive values indicated internal rotation.
c
Positive values indicated posterior tilt.

error would exceed both the SEM and minimal detectable We observed a similar error between the measurement

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change score at 90% CI, such that error .108 would methods during motion in the sagittal plane. Given the
indicate an invalid measurement of scapular motion. difference between methods despite an RMSE of 98 and an
Additionally, previous researchers8,25,26 found that RMSE average difference of 48, we suspect that accessory motion
values .108 indicated inaccurate measures of true scapular from spinal flexion and extension contributed to the overall
motion. In our study, the RMSE values were 108 for all differences in scapular measurement. Although participants
planes of motion. Furthermore, the average difference were orally instructed to not move their spines during each
between the electric goniometer and the 3D motion-capture trial and were closely observed during testing, it was not
system ranged from 78 to 48 across the 3 anatomical possible to eliminate the inherent motion of the spine. This
planes. Taken together, these results suggest that the concept highlights a limitation of calibrating the electric
electric goniometer was capable of measuring scapular goniometer to a standalone vertical surface (I-beam square
motion in each anatomical plane during upper extremity level). To overcome this limitation in the future, we suggest
elevation with a moderate degree of accuracy. calibrating the electric goniometer to the participant’s spine
The RMSE associated with upper extremity elevation in before measuring sagittal-plane motion. This adjustment in
the frontal plane highlights a limitation of using a 3D calibration will ideally capture the inherent trunk position
of the participant and account for any initial spinal offset in
optical motion-capture system with an AMC to capture
the sagittal plane.
scapular motion. The AMC represents the scapula, and its
Although each measurement recorded by the electric
motion was recorded using the 14-camera 3D optical goniometer introduced a specific limitation, the comparison
motion-capture system to represent scapular movement. between mean excursion values recorded by the device and
Placement of the AMC on the posterior acromion was those from previous research is encouraging. Specifically,
difficult and restricted access to the scapular spine. As the average scapular external rotation in our study in the
shown in Figures 1B and 1C, placement of the electric transverse plane (88) was identical to the average scapular
goniometer was limited to the medial aspect of the scapular external rotation that Chu et al8 recorded using the AMC
spine due to the AMC’s position on the acromion. (88) and similar to the value noted by McClure et al3 using
Therefore, the correction factor was applied to frontal- bone pins (68). In addition, the average total excursion of
plane data, the plane of motion most affected by the AMC. scapular posterior tilt recorded using the electric goniom-
The correction reduced the RMSE value from 108 to 78 and eter (188) agreed with the average excursion that Ludewig
increased the associated P value to .96, illustrating no et al2 identified using intracortical measurement techniques
difference between the electric goniometer and the 3D (188). These comparisons with earlier findings using
optical motion-capture system when measuring scapular criterion standard measurement techniques demonstrate
motion in the frontal plane during upper extremity promising capabilities for scapular measurement in each
elevation. anatomical plane during upper extremity elevation.

Table 3. Comparison Between Total Excursion Values Recorded Using the EasyAnglea Electric Goniometer and the 3-Dimensional
Optical Motion-Capture System
8 (Mean 6 SD)
Anatomical Plane EasyAngle 3-Dimensional System Average Difference, 8 Root Mean Square Error, 8 P Value
Frontalb 23 6 6 30 6 7 7 10 ,.001f
Corrected frontalb,c 30 6 6 30 6 7 0 7 .96
Transversed 8 6 5 6 6 7 2 7 .015f
Sagittale 18 6 7 22 6 7 4 9 ,.001f
a
Meloq AB.
b
Positive values indicated downward rotation.
c
Corrected frontal indicates a correction of 78 added to the mean scapular excursion recorded by the EasyAngle in the frontal plane.
d
Positive values indicated internal rotation.
e
Positive values indicated posterior tilt.
f
Indicates difference, accounting for Bonferroni correction (a  .017).

Journal of Athletic Training 591

 A strength of our study was the examination of both the using the electric goniometer can discriminate between
intrarater and interrater reliability. Previous investigations healthy and pathologic states.
of the reliability of clinical measurement of scapular
motion are limited. Reliability values have been de- CONCLUSIONS
scribed23,27 for measurements recorded by a single
examiner between 2 testing sessions on the same day, Ultimately, the results of this investigation demonstrated
whereas in other works,12,28 the authors did not provide the that the IMU-equipped electric goniometer was a reliable
time between testing sessions. We examined both the and moderately valid device to measure scapular motion in
intrarater reliability of the electric goniometer across 2 each anatomical plane during upper extremity elevation in a
testing sessions and the interrater reliability within a single healthy population. The degree of error associated with the
testing session. The average rest position and average device when measuring scapular-motion excursions de-
excursion values from the 3 trials of motion were analyzed pended on soft tissue and palpation restrictions. We
for reliability. To minimize the risk of error between recommend using a clear and defined standard operating
measurement techniques, we used standardized placement procedure when scapular measurements are taken by more
procedures. Our results are consistent with those of than 1 examiner. These findings provide evidence of a

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previous research29 on digital goniometer measurement in clinically portable and consistent device for objectively
finding a higher intrarater than interrater reliability, even measuring scapular motion in the clinical setting.
when a standard procedure was used.
The electric goniometer was reliable for determining both ACKNOWLEDGMENTS
scapular rest position (ICC [2,3] range ¼ 0.692–0.874) and We acknowledge Rui Chen and Denise Conway for the
total excursion (ICC [2,3] range ¼ 0.628–0.790) across an donation of the EasyAngle (Meloq AB) electric goniometer. We
average of 9 days. The associated error was less when we did not receive any financial or monetary gain from Meloq AB.
measured rest position (SEM ¼ 38) than scapular excursions
(SEM range ¼ 28–48). The decrease in ICC values and FINANCIAL DISCLOSURES
increase in SEM between the rest and excursion measure- This work was funded in part by grant No. 1718MGP02 from
ments could be linked to variations in individuals’ the National Athletic Trainers’ Association Research & Education
movement patterns across days. Furthermore, our same- Foundation and in part by grant No. UL1TR001998 from the
day interrater reliability of scapular rest position (ICC [2,3] National Center for Advancing Translational Sciences of the
range ¼ 0.833–0.912) across all 3 anatomical planes was National Institutes of Health to the University of Kentucky Center
higher than that reported by Watson et al27 (ICC range ¼ for Clinical and Translational Science. The content is solely the
0.21–0.52). Reliability for total scapular excursion was also responsibility of the authors and does not necessarily represent the
higher in our study (ICC [2,3] range ¼ 0.545–0.724) than in official views of the National Institutes of Health or the University
the study of Watson et al27 (ICC ¼ 0.23) during upper of Kentucky.
extremity elevation. These results demonstrating increased
interrater reliability support the concept that the electric REFERENCES
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Address correspondence to Tim L. Uhl, PhD, ATC, PT, College of Health Sciences, University of Kentucky, 210C Wethington Building,
900 South Limestone Street, Lexington, KY 40536. Address email to [email protected].

Journal of Athletic Training 593