(1999). Video 1. McKean, M. R. and Burkett, B. J. Injury or spasm of muscles can reduce both active rom and passive rom. With a few cues, a test can be done in seconds. [ Links ], 60. Barlow, J. C., Benjamin, B. W., Birt, P. J., and Hughes, C. J. Also, in terms of palpation to determine “alignment”, the plethora of individual anatomical variance makes determining alignment impossible Also, we are not static structures, mechanical function is of tantamount relevance where “misaligned” bones are a functional irrelevance. Arch Phys Med Rehabil 2006;87(4)576-582. J Spinal Disord 1992a;5(4):383-9. Function, dysfunction, adaptation and enhancement. Figure 1. Typical error values for associated tests to be used as a guide for coaches. DOI: 10.1097/00007632-199507000-00008 Recommended Testing Position. [ Links ], 28. The human body is capable of a wide range of movement. (2015). At maximal shoulder flexion, the smartphone is placed beneath the medial epicondyle, along the triceps muscle. 1. Yet, this method of assessing mobility has major limitations. Measurement: Prior to testing, the smartphone should be calibrated relative to a vertical reference point. The thoracic spine is comprised of 12 vertebrae. [ Links ], 31. Porto Alegre: Artes médicas;1997. Another type of goniometer that presented excellent results was the mobile device goniometer (iPod), with correlations above 0.8 for both intra- and inter-rater reproducibility and concurrent validity40, supporting the agreement between the measures taken by different raters and at different times. June 02, 2017; Accepted: Repeatability describes the degree of equality between obtained results, based on consecutive measurements performed by the same rater, using the same instrument and method((11)). Post-treatment thoracic range of motion saw an average increase of 12.02 degrees +/- 1.65 from pre-treatment range of motion. DOI: 10.1155/2012/186156 Former Olympic athlete Craig Pickering explains why treating errors as systemic problems can be the best way to improve performance and prevent injury. [ Links ], 40. Study design and method: Repeated measures design. Validity (with Fastrak) of lumbar flexion and extension, Intra-rater reproducibility: ICC: 0.90-0.98. This allows us to collect objective data that is reliable, while being able to identify the presence of a mobility deficit. However, I have found this test to be highly reliable. “The intra-and inter-rater reliability of the tragus wall distance (TWD) measurement in non-pathological participants ages 18–34.” Physiotherapy Theory and Practice, 29(4), 328–334. The 12 vertebrae of the thoracic spine form a curve that is convex posteriorly ().This sagittal plane curve is referred to as the thoracic kyphosis, which ranges from 20 to 50 degrees when assessed radiographically. 19. Regarding the concurrent validity of the instruments, the studies that tested it presented limitations; for instance, the concurrent validity of some inclinometers and goniometers were compared to inclinometers, which are not considered the gold standard for movement assessment68. I also recommend coaches be cautious about using different phone models interchangeably. [ Links ], 6. 16. However, Burton’s study51 assessed only one individual, and its results only showed superior angulation (greater by one degree) when compared to X-rays. To monitor the effectiveness of your training intervention and identify what strategies develop mobility, you need assessment techniques that provide objective, accurate, reliable data. [ Links ], 45. Porto Alegre: Artmed; 2014. Crosbie, J., Kilbreath, S. L., Hollmann, L., and York, S. (2008). To make the execution of these tests even more challenging for coaches, many ROM assessments require exceptional palpatory skills. Int J Sports Phys Ther 2013;8(2):129-137. This week’s Friday Five is with Steve Barrett, a sport scientist and researcher who investigates human performance. Measurement of regional lumbar sagittal mobility. Note: Heterogeneity test: Q=5.01; DF=1; p=0.025; I²=80.05%; 95% IC for I²=14.25 - 95.36. [ Links ], 43. Main outcome measure(s): We tested 5 thoracic rotation ROM techniques over 2 days: seated rotation (bar in back and front), half-kneeling rotation (bar in back and front), and lumbar-locked rotation. Reliability and validity of non-radiographic methods of thoracic kyphosis measurement: a systematic review. Intra- and inter-rater reproducibility with ICC> 0.9. Alter, MJ. 10. Consmuller T, Rohlmann A, Weinland D, Druschel C, Duda G, Taylor W. Comparative evaluation of a novel measurement tool to assess lumbar spine posture and range of motion. Validity of lumbar flexion and extension, Intra-rater reproducibility: Flexion: Gravity Goniometer: ICC: 0.91; Parallelogram Goniometer: ICC: 0.92; Extension: Gravity Goniometer: ICC: 0.71; Parallelogram Goniometer: ICC: 0.60; Validity: Flexion: Gravity Goniometer: ICC: -0.11; Parallelogram Goniometer: ICC: 0.19; Extension: Gravity Goniometer: ICC: -0.73; Parallelogram Goniometer: ICC: -0.71, Flexion: MAD: 3.80±2.95; Extension: MAD: 3.10±1.98, Repeatability and validity (two inclinometers) of trunk flexion, Validity: r: 0.97; Repeatability: ICC: 0.98. However, there is scientific evidence only to support the inter-rater reproducibility of the measuring tape instrument only in the modified Schöber’s test for lumbar flexion movement, and the intra-rater reproducibility of the Flexicurve and video analysis system instruments for lumbar extension and flexion movements. J Orthop Sports Phys Ther 1994;20(4):207-212. [ Links ], 2. “Humeral retroversion and its relationship to glenohumeral rotation in the shoulder of college baseball players.” The American Journal of Sports Medicine, 30(3), 354–360. Note: Heterogeneity test: Q=1.29; DF=1; p=0.256; I²=22.53%; 95% IC for I²=0.00 - 100.00. Prior to this position, Howe lectured for the Strength and Conditioning undergraduate and postgraduate degrees at St Mary’s University, where he also provided strength and conditioning services to a group of international track and field athletes. Intra-rater reproducibility of thoracolumbar flexion and extension. Eur J Phys Rehabil Med 1995;5(4):122-125. Associação Brasileira de NormasTécnicas - ABNT. Ergonomics 1994;37(1):175-185. [ Links ], 26. Rondinelli R, Murphy J, Esler A, Marciano T, Cholmakjian C. Estimation of normal lumbar flexion with surface inclinometry. Furthermore, measurement protocols, in general, have adequate intra- and inter-rater repeatability and reproducibility (Table 1), which makes it possible to use them to follow up spinal training and treatments, since measurements can be reliably performed at different times, as well as by different raters. Finally, reproducibility, which can be measured intra-rater and inter-rater, describes the degree of equality between results obtained in tests conducted by the same rater or by different raters, respectively, using the same instrument and method((11)). [ Links ], 12. Other instruments such as photogrammetry57, optical fiber system61 and electromagnetic device (3 Space Isotrack System)47 have been described in few studies for spinal ROM assessment, and still lack further information on their validity aspects. The athlete is cued to make a fist with both hands and bring the knuckles together directly above the head. [ Links ], 48. Correia VG, Foganholi G, Macedo CSG. Barret E, McCreesh K, Lewis J. Center. 6. An athlete passes the pectoralis major length test when they are able to comfortably rest the arm on the ground. [ Links ], 34. [ Links ], 46. In fact, because this data was collected by researchers with a different skill set than your own, using a population that likely differs from the athletes you work with, I suggest you establish your own reliability data for each test using the statistical procedures outlined by Spence and Cushion.17. Understanding this can help from a programming perspective. Salisbury PJ, Porter R. Measurement of lumbar sagittal mobility: A comparison of methods. Table 11 Meta-analysis result for inter-rater reproducibility of the video analysis system instrument for lumbar flexion movement. Only included studies were subjected to data extraction, analysis of quality and risk of bias. Med Eng Phys 2003;25:817-824. DOI:10.1016/j.clinbiomech.2011.01.015 Man Ther 2014;19:10-17. It should be noted that low cost, easy handling and the fact of providing quantitative results, presenting values in centimeters (cm), are factors that can facilitate the widespread use of this instrument. Kinematics of human motion. This movement occurs in the various areas of the body including the spine and extremities. “Test-retest reliability of seven common clinical tests for assessing lower extremity muscle flexibility in futsal and handball players.” Physical Therapy in Sport, 16(2), 107–113. Main Outcome Measure(s): We tested 5 thoracic rotation ROM techniques over 2 days: seated rotation (bar in back and front), half-kneeling rotation (bar in back and front), and lumbar-locked rotation. Note: Heterogeneity test: Q=1.99; DF=2; p=0.369; I²=0.00%; 95% IC for I²=0.00 - 96.63. This is where measuring distances can be a problem. To avoid the need to Google “tragus,” it’s the semi-circular flap that covers the auditory meatus. Mayo Clinic Proc 1986;61(3):192-197. The Flexicurve instrument is a flexible lead ruler, 30 to 80 cm long, easy to use, low-cost, and serves as a diagnostic means and evolutionary treatment indicator for field studies in large populations67. Intra-, inter-rater reproducibility and validity (inclinometer) of lumbar and trunk flexion and extension. “Reliability of thoracic spine rotation range-of-motion measurements in healthy adults.” Journal of Athletic Training, 47(1), 52–60. Additionally, I have added some clinical pearls for thoracic anatomy and biomechanics! The pelvis is posteriorly rotated to prevent compensations at the spine. In this post, I will be reviewing the active range of motion and segmental mobility assessments for the thoracic spine. DOI: 10.1109/IEMBS.2008.4649247 An example of this approach is the weight-bearing lunge test for the ankle joint, where the toe-to-wall distance is measured to represent dorsiflexion capacity. DOI: 10.3233/BMR-130431 [ Links ], 57. Shipe, N. K., Billek-Sawhney, B., Canter, T. A., Meals, D. J., Nestler, J. M., and Stumpff, J. L. (2013). 5 A variety of methods have been proposed to measure thoracic spine rotation, 5, 10–15 but the reliability of these measures has not been established. 3. Table 4 Meta-analysis for intra-rater reproducibility of the Flexicurve instrument for lumbar extension movement. [ Links ], 22. DOI:10.1111/j.1365-2753.2011.01707.x measures of spinal posture and move-ment in clinical practice and large-scale clinical studies.24 Clinical guidelines for measurement of thoracic sagittal motion recommend that range of motion in extension be de-fined with reference to the magnitude of the kyphosis measured in standing.9 Previous studies of thoracic extension Not all of the data presented was collected using a smartphone to determine the clinometric properties of the assessment, so I’ve included a column indicating the equipment used for each study. Copyright © 2020 SimpliFaster. Not all free applications allow you to zero the smartphone, which should be a consideration when selecting an application to perform ROM assessments. This scale consists of a 13-item checklist15. [ Links ], 49. Motion. The search terms used, with their respective Boolean operators, were Spine [AND] Evaluation [OR] Measurement [AND] Reproducibility of Results [OR] Reliability [OR] Validity [AND] Range of Motion, Articular [OR] Range of Motion [OR] Motion [OR] Pliability [OR] Flexibility. Arch Phys Med Rehabil 2004;1(85):99-103. Part I. Mayer RS, Chen I, Lavender SA, Trafimow JH, Andersson GBJ. Spine 1991;16(1):29-33. , Press, J. M., McClure, P., and vibration sensors structures using a computerized compared...: reproducibility of the attraction method for the thoracic spine rotation.” Journal of shoulder and elbows flexed to 90.... R. measurement of lumbar flexion movement back movement the clean to data Extraction, analysis quality. 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