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. 2021 Dec;29(6):360-366.
doi: 10.1080/10669817.2021.1930861. Epub 2021 May 24.

Relationship of clinical measures with humeral torsion in young adults: a pilot study

David M Werner  1   2   3 , Eric V Bellm  4 , Joseph M Day  1
Affiliations

Relationship of clinical measures with humeral torsion in young adults: a pilot study

David M Werner et al. J Man Manip Ther. 2021 Dec.

Abstract

Purpose: Humeral retroversion alters range of motion and has been linked to injury risk. Clinically,palpation of the bicipital groove is used to quantify humeral torsion, but the accuracy of this procedure has not been fully examined. The purpose of this study was to investigate the relationship between clinical and diagnostic ultrasound (US) assessment of humeral torsion while considering shoulder position of the participant and clinical expertise of the examiner.

Methods: Seventeen participants (34 shoulders, 16/17 right handed, 10/17 history of throwing) were recruited. US was assessed by an experienced assessor. Two clinical assessments of humeral torsion were performed by two assessors of different experience (expert and novice). Humeral torsion was assessed at 90 degrees shoulder abduction (Palp90) and 45 degrees shoulder abduction (Palp45). Within assessor intraclass correlation coefficients (ICC (3, 1) were calculated. Correlation coefficients (Pearson's) were generated to determine relationship between clinical and US examination findings.

Results: Intra-rater reliability for clinical tests were good (ICCs .73 - .92) for both raters. Of the palpation tests, only the expert assessor was significantly correlated to the US measurement (p<.001) at Palp45 (r = .64) and Palp90 (r = .62). For the expert, there was a significantly lower angle calculated for Palp45 compared to Palp90 (p<.001).

Conclusion: The accuracy of both palpation methods for assessing humeral retrotorsion may depend on the training background of the assessor. Further, the glenohumeral position of the patient during palpation should be consistent for the purposes of repeated testing.

Keywords: Ultrasound; manual therapy; overhead athlete; palpation; shoulder.

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Figures

Figure 1.
Figure 1.
A. Arm and transducer placement for ultrasound assessment. B – Image of landmarks for ultrasound assessment
Figure 2.
Figure 2.
A. Palpation based assessment with shoulder at 90° abduction. B – Palpation based assessment with shoulder at 45° abduction
Figure 3.
Figure 3.
Figure 4.
Figure 4.
See this image and copyright information in PMC

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