Serratus anterior is portrayed as a homogenous muscle in textbooks and during functional activiti... more Serratus anterior is portrayed as a homogenous muscle in textbooks and during functional activities and rehabilitation exercises. It is unclear whether serratus anterior is composed of subdivisions with distinctive morphology and functions. The purpose of this study was to determine if serratus anterior could be subdivided into different structural parts on the basis of its segmental architectural parameters. Eight formalin-embalmed serratus anterior muscles were dissected and the attachments of each fascicle documented. Orientation and size of each fascicle was measured and the physiological cross-sectional area (PCSA) calculated. Three subdivisions of serratus anterior were identified. A new finding was the discovery of two distinctive fascicles attached to the superior and inferior aspects of rib 2. The rib 2 inferior fascicle had the largest PCSA (mean 1.6 cm2) and attached, with the rib 3 fascicle, along the medial border of scapula to form the middle division. The rib 2 superior and rib 1 fascicles attached to the superior angle of scapula (upper division). Fascicles from ribs 4 to 8/9 attached to the inferior angle of scapula (lower division). Mean fascicle angle relative to a vertical midline reference and PCSA for each division were 29o and 1.3 cm2 (upper), 90o and 2.2 cm2 (middle), and 59o and 3.0 cm2 (lower). This novel study demonstrated the presence of morphologically distinct serratus anterior subdivisions. The results of this study will inform the development of optimal techniques for the assessment, treatment and rehabilitation of this architecturally complex muscle in shoulder and neck pain.
Scandinavian journal of medicine & science in sports, 2011
Abnormalities of scapular positioning are considered important risk factors for developing should... more Abnormalities of scapular positioning are considered important risk factors for developing shoulder disorders. This study analyses the scapular positioning pattern in a group of overhead athletes with and without shoulder pain. In a multi-center blinded case-control study, 36 shoulder pain athletes (19 men, 17 women), were compared with 36 unimpaired athletes free of shoulder pain, matched for gender, age, hand dominance and body mass index. The blinded assessor performed visual observation, the measurement of the distance between the acromion and the table, inclinometry and the kinetic medial rotation test for dynamic scapular control in random order. Athletes with shoulder pain demonstrate scapular asymmetry in the sagittal plane, observed visually as anterior tilting on the painful side. Athletes with shoulder pain show a lack of scapular motor control on their painful side in contrast to their pain-free side. No scapular positioning or motor control differences were found in ath...
Abstract: "The aim of this study was to assess the potential of employing a classification tool to... more Abstract: "The aim of this study was to assess the potential of employing a classification tool to objectively classify participants with clinically assessed movement faults (MFs) of the scapula. Six participants with a history of shoulder pain with MFs of the scapula and 12 healthy participants with no movement faults (NMFs) performed a flexion movement control test of the scapula, while scapular kinematic data were collected. Principal component scores and discrete kinematic variables were used as input into a classifier. Five out of the six participants with a history of pain were successfully classified as having scapular MFs with an accuracy of 72%. Variables related to the upward rotation of the scapula had the most influence on the classification. The results of the study demonstrate the potential of adopting a multivariate approach in objective classification of participants with altered scapular kinematics in pathological groups."
Abstract
Pre-season screening is well established within the sporting arena, and aims to enhance... more Abstract
Pre-season screening is well established within the sporting arena, and aims to enhance performance and reduce injury risk. With the increasing need to identify potential injury with greater accuracy, a new risk assessment process has been produced; The Performance Matrix (battery of movement control tests). As with any new method of objective testing, it is fundamental to establish whether the same results can be reproduced between examiners and by the same examiner on consecutive occasions. This study aimed to determine the intra-rater test re-test and inter-rater reliability of tests from a component of The Perfor-mance Matrix, The Foundation Matrix. Twenty participants were screened by two experienced musculoskeletal therapists using nine tests to assess the ability to control movement during specific tasks. Movement evaluation criteria for each test were rated as pass or fail. The therapists observed participants real-time and tests were recorded on video to enable repeated ratings four months later to examine intra-rater reliability (videos rated two weeks apart). Overall test percentage agreement was 87% for inter-rater reliability; 98% Rater 1, 94% Rater 2 for test re-test reliability; and 75% for real-time versus video. Intraclass-correlation coefficients (ICCs) were excellent between raters (0.81) and within raters (Rater 1, 0.96; Rater 2, 0.88) but poor for real-time versus video (0.23). Reliability for individual components of each test was more variable: inter-rater, 68-100%; intra-rater, 88-100% Rater 1, 75-100% Rater 2; and real-time versus video 31-100%. Cohen’s Kappa values for inter-rater reliability were 0.0-1.0; intra-rater 0.6-1.0 for Rater 1; -0.1-1.0 for Rater 2; and -0.1-1 for real-time versus video. It is con-cluded that both inter and intra-rater reliability of tests in The Foundation Matrix are acceptable when rated by experienced therapists. Recommendations are made for modifying some of the criteria to improve reliability where excellence was not reached.
Working Papers in the Health Sciences 2016; 1:15 Spring: 1-12., 2016
Objective: To determine the intra-rater reliability of a newly developed movement screening tool;... more Objective: To determine the intra-rater reliability of a newly developed movement screening tool; the ‘Movement control screen for older people in community settings’. The movement screening tool aims to identify movement control impairments which can potentially influence movement function. Method: Thirty one active female recreational golfers, aged 65-77 years, carried out three movement control tests included in the screening tool. Performance was video-recorded to enable repeated ratings. Each test was evaluated by criteria which were rated as pass or fail and ratings were carried out three weeks apart to examine intra-rater reliability. Reliability was assessed using percentage agreement and Cohen’s Kappa. Results: Percentage agreement for each test ranged from 93.0-97.3%, with an overall mean agreement of 95.5%. Kappa values for test scores ranged from 0.35-0.90. Percentage agreement for individual criteria ranged from 83.0-100.0%, with kappa values ranging from 0.00-1.00. Discussion: Acceptable intra-rater reliability was established for overall tests scores of the screening tool but certain criteria were identified as being less reliable than others. Recommendations are made for refinement of some criteria to improve reliability of the screening tool.
SUMMARY. The ability to position and control movements of the scapula is essential for optimal up... more SUMMARY. The ability to position and control movements of the scapula is essential for optimal upper limb function. The inability to achieve this stable base frequently accompanies the development of shoulder and upper limb pain and pathology. Unlike other joints the bony, capsular and ligamentous constraints are minimal at the scapulothoracic 'joint' so stability is dependant on active control. Clinically, it is noted that patients presenting with shoulder and arm symptoms demonstrate poor dynamic scapula control. Scapula setting is an exercise taught by physiotherapists to correct movement dysfunction associated with abnormal scapula positioning and dynamic control. Addressing the dynamic stabilization of the scapula is an essential part of the management of neuromusculoskeletal dysfunction of the shoulder girdle and an appropriate rehabilitation programme is necessary if this issue is to be addressed. Copyright 1997 Harcourt Publishers Ltd.
Pre-season screening is well established within the sporting arena, and aims to enhance performan... more Pre-season screening is well established within the sporting arena, and aims to enhance performance and reduce injury risk. With the increasing need to identify potential injury with greater accuracy, a new risk assessment process has been produced; The Performance Matrix (battery of movement control tests). As with any new method of objective testing, it is fundamental to establish whether the same results can be reproduced between examiners and by the same examiner on consecutive occasions. This study aimed to determine the intra-rater test re-test and inter-rater reliability of tests from a component of The Performance Matrix, The Foundation Matrix. Twenty participants were screened by two experienced musculoskeletal therapists using nine tests to assess the ability to control movement during specific tasks. Movement evaluation criteria for each test were rated as pass or fail. The therapists observed participants real-time and tests were recorded on video to enable repeated rati...
Pre-season screening is routinely promoted as part of either an injury risk management strategy o... more Pre-season screening is routinely promoted as part of either an injury risk management strategy or as a performance enhancement strategy. Many of these processes focus on testing joint range, muscle strength (both power and endurance) and testing muscle extensibility. Although some functional tests based on work specific tasks and sport specific skills are applied they are specific to one task or a sport specific skill. It seems that the clinical outcomes of asymptomatic function, normal range of joint motion (isolated testing) and normal muscle strength (isolated testing) are not adequate rehabilitation end points to prevent recurrence. This Masterclass explores assessment and retraining from a new perspective in an attempt to address multiple muscle interactions acting on multiple joints in functionally orientated tasks. The assessment is based on the specific assessment of the site and direction of uncontrolled movement, under low and high threshold loading at different joint systems within functionally orientated tasks. From this assessment, a specific retraining programme can be developed and implemented.
... Canadian Journal of Surgery, 12 (1969), pp. 181187. 6 S Brumagne, R Lysens, S Swinnen and S ... more ... Canadian Journal of Surgery, 12 (1969), pp. 181187. 6 S Brumagne, R Lysens, S Swinnen and S Verschueren, Effect of paraspinal muscle vibration on position of lumbosacral spine. Spine, 24 (1999), pp. 13281331. ... Experimental Brain Research Jan, 124 (1999), pp. 6979. ...
Serratus anterior is portrayed as a homogenous muscle in textbooks and during functional activiti... more Serratus anterior is portrayed as a homogenous muscle in textbooks and during functional activities and rehabilitation exercises. It is unclear whether serratus anterior is composed of subdivisions with distinctive morphology and functions. The purpose of this study was to determine if serratus anterior could be subdivided into different structural parts on the basis of its segmental architectural parameters. Eight formalin-embalmed serratus anterior muscles were dissected and the attachments of each fascicle documented. Orientation and size of each fascicle was measured and the physiological cross-sectional area (PCSA) calculated. Three subdivisions of serratus anterior were identified. A new finding was the discovery of two distinctive fascicles attached to the superior and inferior aspects of rib 2. The rib 2 inferior fascicle had the largest PCSA (mean 1.6 cm2) and attached, with the rib 3 fascicle, along the medial border of scapula to form the middle division. The rib 2 superior and rib 1 fascicles attached to the superior angle of scapula (upper division). Fascicles from ribs 4 to 8/9 attached to the inferior angle of scapula (lower division). Mean fascicle angle relative to a vertical midline reference and PCSA for each division were 29o and 1.3 cm2 (upper), 90o and 2.2 cm2 (middle), and 59o and 3.0 cm2 (lower). This novel study demonstrated the presence of morphologically distinct serratus anterior subdivisions. The results of this study will inform the development of optimal techniques for the assessment, treatment and rehabilitation of this architecturally complex muscle in shoulder and neck pain.
Scandinavian journal of medicine & science in sports, 2011
Abnormalities of scapular positioning are considered important risk factors for developing should... more Abnormalities of scapular positioning are considered important risk factors for developing shoulder disorders. This study analyses the scapular positioning pattern in a group of overhead athletes with and without shoulder pain. In a multi-center blinded case-control study, 36 shoulder pain athletes (19 men, 17 women), were compared with 36 unimpaired athletes free of shoulder pain, matched for gender, age, hand dominance and body mass index. The blinded assessor performed visual observation, the measurement of the distance between the acromion and the table, inclinometry and the kinetic medial rotation test for dynamic scapular control in random order. Athletes with shoulder pain demonstrate scapular asymmetry in the sagittal plane, observed visually as anterior tilting on the painful side. Athletes with shoulder pain show a lack of scapular motor control on their painful side in contrast to their pain-free side. No scapular positioning or motor control differences were found in ath...
Abstract: "The aim of this study was to assess the potential of employing a classification tool to... more Abstract: "The aim of this study was to assess the potential of employing a classification tool to objectively classify participants with clinically assessed movement faults (MFs) of the scapula. Six participants with a history of shoulder pain with MFs of the scapula and 12 healthy participants with no movement faults (NMFs) performed a flexion movement control test of the scapula, while scapular kinematic data were collected. Principal component scores and discrete kinematic variables were used as input into a classifier. Five out of the six participants with a history of pain were successfully classified as having scapular MFs with an accuracy of 72%. Variables related to the upward rotation of the scapula had the most influence on the classification. The results of the study demonstrate the potential of adopting a multivariate approach in objective classification of participants with altered scapular kinematics in pathological groups."
Abstract
Pre-season screening is well established within the sporting arena, and aims to enhance... more Abstract
Pre-season screening is well established within the sporting arena, and aims to enhance performance and reduce injury risk. With the increasing need to identify potential injury with greater accuracy, a new risk assessment process has been produced; The Performance Matrix (battery of movement control tests). As with any new method of objective testing, it is fundamental to establish whether the same results can be reproduced between examiners and by the same examiner on consecutive occasions. This study aimed to determine the intra-rater test re-test and inter-rater reliability of tests from a component of The Perfor-mance Matrix, The Foundation Matrix. Twenty participants were screened by two experienced musculoskeletal therapists using nine tests to assess the ability to control movement during specific tasks. Movement evaluation criteria for each test were rated as pass or fail. The therapists observed participants real-time and tests were recorded on video to enable repeated ratings four months later to examine intra-rater reliability (videos rated two weeks apart). Overall test percentage agreement was 87% for inter-rater reliability; 98% Rater 1, 94% Rater 2 for test re-test reliability; and 75% for real-time versus video. Intraclass-correlation coefficients (ICCs) were excellent between raters (0.81) and within raters (Rater 1, 0.96; Rater 2, 0.88) but poor for real-time versus video (0.23). Reliability for individual components of each test was more variable: inter-rater, 68-100%; intra-rater, 88-100% Rater 1, 75-100% Rater 2; and real-time versus video 31-100%. Cohen’s Kappa values for inter-rater reliability were 0.0-1.0; intra-rater 0.6-1.0 for Rater 1; -0.1-1.0 for Rater 2; and -0.1-1 for real-time versus video. It is con-cluded that both inter and intra-rater reliability of tests in The Foundation Matrix are acceptable when rated by experienced therapists. Recommendations are made for modifying some of the criteria to improve reliability where excellence was not reached.
Working Papers in the Health Sciences 2016; 1:15 Spring: 1-12., 2016
Objective: To determine the intra-rater reliability of a newly developed movement screening tool;... more Objective: To determine the intra-rater reliability of a newly developed movement screening tool; the ‘Movement control screen for older people in community settings’. The movement screening tool aims to identify movement control impairments which can potentially influence movement function. Method: Thirty one active female recreational golfers, aged 65-77 years, carried out three movement control tests included in the screening tool. Performance was video-recorded to enable repeated ratings. Each test was evaluated by criteria which were rated as pass or fail and ratings were carried out three weeks apart to examine intra-rater reliability. Reliability was assessed using percentage agreement and Cohen’s Kappa. Results: Percentage agreement for each test ranged from 93.0-97.3%, with an overall mean agreement of 95.5%. Kappa values for test scores ranged from 0.35-0.90. Percentage agreement for individual criteria ranged from 83.0-100.0%, with kappa values ranging from 0.00-1.00. Discussion: Acceptable intra-rater reliability was established for overall tests scores of the screening tool but certain criteria were identified as being less reliable than others. Recommendations are made for refinement of some criteria to improve reliability of the screening tool.
SUMMARY. The ability to position and control movements of the scapula is essential for optimal up... more SUMMARY. The ability to position and control movements of the scapula is essential for optimal upper limb function. The inability to achieve this stable base frequently accompanies the development of shoulder and upper limb pain and pathology. Unlike other joints the bony, capsular and ligamentous constraints are minimal at the scapulothoracic 'joint' so stability is dependant on active control. Clinically, it is noted that patients presenting with shoulder and arm symptoms demonstrate poor dynamic scapula control. Scapula setting is an exercise taught by physiotherapists to correct movement dysfunction associated with abnormal scapula positioning and dynamic control. Addressing the dynamic stabilization of the scapula is an essential part of the management of neuromusculoskeletal dysfunction of the shoulder girdle and an appropriate rehabilitation programme is necessary if this issue is to be addressed. Copyright 1997 Harcourt Publishers Ltd.
Pre-season screening is well established within the sporting arena, and aims to enhance performan... more Pre-season screening is well established within the sporting arena, and aims to enhance performance and reduce injury risk. With the increasing need to identify potential injury with greater accuracy, a new risk assessment process has been produced; The Performance Matrix (battery of movement control tests). As with any new method of objective testing, it is fundamental to establish whether the same results can be reproduced between examiners and by the same examiner on consecutive occasions. This study aimed to determine the intra-rater test re-test and inter-rater reliability of tests from a component of The Performance Matrix, The Foundation Matrix. Twenty participants were screened by two experienced musculoskeletal therapists using nine tests to assess the ability to control movement during specific tasks. Movement evaluation criteria for each test were rated as pass or fail. The therapists observed participants real-time and tests were recorded on video to enable repeated rati...
Pre-season screening is routinely promoted as part of either an injury risk management strategy o... more Pre-season screening is routinely promoted as part of either an injury risk management strategy or as a performance enhancement strategy. Many of these processes focus on testing joint range, muscle strength (both power and endurance) and testing muscle extensibility. Although some functional tests based on work specific tasks and sport specific skills are applied they are specific to one task or a sport specific skill. It seems that the clinical outcomes of asymptomatic function, normal range of joint motion (isolated testing) and normal muscle strength (isolated testing) are not adequate rehabilitation end points to prevent recurrence. This Masterclass explores assessment and retraining from a new perspective in an attempt to address multiple muscle interactions acting on multiple joints in functionally orientated tasks. The assessment is based on the specific assessment of the site and direction of uncontrolled movement, under low and high threshold loading at different joint systems within functionally orientated tasks. From this assessment, a specific retraining programme can be developed and implemented.
... Canadian Journal of Surgery, 12 (1969), pp. 181187. 6 S Brumagne, R Lysens, S Swinnen and S ... more ... Canadian Journal of Surgery, 12 (1969), pp. 181187. 6 S Brumagne, R Lysens, S Swinnen and S Verschueren, Effect of paraspinal muscle vibration on position of lumbosacral spine. Spine, 24 (1999), pp. 13281331. ... Experimental Brain Research Jan, 124 (1999), pp. 6979. ...
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Pre-season screening is well established within the sporting arena, and aims to enhance performance and reduce injury risk. With the increasing need to identify potential injury with greater accuracy, a new risk assessment process has been produced; The Performance Matrix (battery of movement control tests). As with any new method of objective testing, it is fundamental to establish whether the same results can be reproduced between examiners and by the same examiner on consecutive occasions. This study aimed to determine the intra-rater test re-test and inter-rater reliability of tests from a component of The Perfor-mance Matrix, The Foundation Matrix. Twenty participants were screened by two experienced musculoskeletal therapists using nine tests to assess the ability to control movement during specific tasks. Movement evaluation criteria for each test were rated as pass or fail. The therapists observed participants real-time and tests were recorded on video to enable repeated ratings four months later to examine intra-rater reliability (videos rated two weeks apart). Overall test percentage agreement was 87% for inter-rater reliability; 98% Rater 1, 94% Rater 2 for test re-test reliability; and 75% for real-time versus video. Intraclass-correlation coefficients (ICCs) were excellent between raters (0.81) and within raters (Rater 1, 0.96; Rater 2, 0.88) but poor for real-time versus video (0.23). Reliability for individual components of each test was more variable: inter-rater, 68-100%; intra-rater, 88-100% Rater 1, 75-100% Rater 2; and real-time versus video 31-100%. Cohen’s Kappa values for inter-rater reliability were 0.0-1.0; intra-rater 0.6-1.0 for Rater 1; -0.1-1.0 for Rater 2; and -0.1-1 for real-time versus video. It is con-cluded that both inter and intra-rater reliability of tests in The Foundation Matrix are acceptable when rated by experienced therapists. Recommendations are made for modifying some of the criteria to improve reliability where excellence was not reached.
Method: Thirty one active female recreational golfers, aged 65-77 years, carried out three movement control tests included in the screening tool. Performance was video-recorded to enable repeated ratings. Each test was evaluated by criteria which were rated as pass or fail and ratings were carried out three weeks apart to examine intra-rater reliability. Reliability was assessed using percentage agreement and Cohen’s Kappa.
Results: Percentage agreement for each test ranged from 93.0-97.3%, with an overall mean agreement of 95.5%. Kappa values for test scores ranged from 0.35-0.90. Percentage agreement for individual criteria ranged from 83.0-100.0%, with kappa values ranging from 0.00-1.00.
Discussion: Acceptable intra-rater reliability was established for overall tests scores of the screening tool but certain criteria were identified as being less reliable than others. Recommendations are made for refinement of some criteria to improve reliability of the screening tool.
Pre-season screening is well established within the sporting arena, and aims to enhance performance and reduce injury risk. With the increasing need to identify potential injury with greater accuracy, a new risk assessment process has been produced; The Performance Matrix (battery of movement control tests). As with any new method of objective testing, it is fundamental to establish whether the same results can be reproduced between examiners and by the same examiner on consecutive occasions. This study aimed to determine the intra-rater test re-test and inter-rater reliability of tests from a component of The Perfor-mance Matrix, The Foundation Matrix. Twenty participants were screened by two experienced musculoskeletal therapists using nine tests to assess the ability to control movement during specific tasks. Movement evaluation criteria for each test were rated as pass or fail. The therapists observed participants real-time and tests were recorded on video to enable repeated ratings four months later to examine intra-rater reliability (videos rated two weeks apart). Overall test percentage agreement was 87% for inter-rater reliability; 98% Rater 1, 94% Rater 2 for test re-test reliability; and 75% for real-time versus video. Intraclass-correlation coefficients (ICCs) were excellent between raters (0.81) and within raters (Rater 1, 0.96; Rater 2, 0.88) but poor for real-time versus video (0.23). Reliability for individual components of each test was more variable: inter-rater, 68-100%; intra-rater, 88-100% Rater 1, 75-100% Rater 2; and real-time versus video 31-100%. Cohen’s Kappa values for inter-rater reliability were 0.0-1.0; intra-rater 0.6-1.0 for Rater 1; -0.1-1.0 for Rater 2; and -0.1-1 for real-time versus video. It is con-cluded that both inter and intra-rater reliability of tests in The Foundation Matrix are acceptable when rated by experienced therapists. Recommendations are made for modifying some of the criteria to improve reliability where excellence was not reached.
Method: Thirty one active female recreational golfers, aged 65-77 years, carried out three movement control tests included in the screening tool. Performance was video-recorded to enable repeated ratings. Each test was evaluated by criteria which were rated as pass or fail and ratings were carried out three weeks apart to examine intra-rater reliability. Reliability was assessed using percentage agreement and Cohen’s Kappa.
Results: Percentage agreement for each test ranged from 93.0-97.3%, with an overall mean agreement of 95.5%. Kappa values for test scores ranged from 0.35-0.90. Percentage agreement for individual criteria ranged from 83.0-100.0%, with kappa values ranging from 0.00-1.00.
Discussion: Acceptable intra-rater reliability was established for overall tests scores of the screening tool but certain criteria were identified as being less reliable than others. Recommendations are made for refinement of some criteria to improve reliability of the screening tool.