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Chiropractic Research Review

Shoulder Position May Influence Goniometric Assessment of ROM

The universal goniometer is the most commonly used tool for measuring range of motion (ROM) at large joints such as the shoulder and hip. Reliability of goniometric measurements can be critical in that repeated assessments are often used by health care providers to establish appropriate rehabilitation protocols and tracking treatment outcomes.

When one doctor takes multiple measurements from a patient over time, the term used to describe the likeness of the results is "intrarater reliability." When two or more doctors perform the measurements and compare their results, the term used is "interrater reliability."

This study examined the intrarater reliability for measurements of active and passive shoulder flexion and abduction, specifically comparing motions as assessed in sitting vs. supine positions. Eleven inpatients and 19 students at a rehabilitation facility and university were measured eight times for each of the two shoulder motions: two passive and two active measurements while sitting and two passive and two active measurements while supine.

Results: High intrarater reliability was noted for both active and passive measurements, regardless of whether the testing was administered with subjects in the supine or sitting positions. When comparing measurements taken in the two different positions, reliability declined to the moderate range.

The authors conclude: "Based on these findings, therapists and others who evaluate shoulder ROM can anticipate similar reliability of measurements, regardless of whether the sitting or supine position is used." However, they also note that the position of testing should be routinely recorded and that a consistent position should be utilized for all clinical measures involving a given subject.

Sabari JS, Maltzev I, Lubarsky D, et al. Goniometric testing of shoulder range of motion: comparison of testing in supine and sitting positions. Archives of Physical Medicine & Rehabilitation, June 1998:79, pp647-51.

Chiropractic Research Review

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