The reliability of humerothoracic angles during arm elevation depends on the representation of rotations

Abstract

The reliability of joint rotation measurements is an issue of major interest, especially in clinical applications. The effect of instrumental errors and soft tissue artifacts on the variability of human motion measures is well known, but the influence of the representation of joint motion has not yet been studied. The aim of the study was to compare the within-subject reliability of three rotation formalisms for the calculation of the shoulder elevation joint angles. Five repetitions of humeral elevation in the scapular plane of 27 healthy subjects were recorded using a stereophotogrammetry system. The humerothoracic joint angles were calculated using the YX'Y" and XZ'Y" Euler angle sequences and the attitude vector. A within-subject repeatability study was performed for the three representations. ICC, SEM and CV were the indices used to estimate the error in the calculation of the angle amplitudes and the angular waveforms with each method. Excellent results were obtained in all representations for the main angle (elevation), but there were remarkable differences for axial rotation and plane of elevation. The YX'Y" sequence generally had the poorest reliability in the secondary angles. The XZ'Y' sequence proved to be the most reliable representation of axial rotation, whereas the attitude vector had the highest reliability in the plane of elevation. These results highlight the importance of selecting the method used to describe the joint motion when within-subjects reliability is an important issue of the experiment. This may be of particular importance when the secondary angles of motions are being studied.

Keywords: Human motion analysis; Minimal clinically important difference; Reliability; Rotation sequence; Shoulder kinematics.