A new method of measuring shoulder hand behind back movement: Reliability, values in symptomatic and asymptomatic people, effect of hand dominance, and side-to-side variability

Abstract

Shoulder hand behind back (HBB) range of motion (ROM) is a useful measure of impairment and treatment outcome. The purpose of this repeated measures study was to identify inter- and intra-rater reliability, of a new simplified method of measuring HBB ROM. Two experienced raters measured HBB ROM with a bubble inclinometer on 25 people (aged 42–75 years, 14 female) with unilateral shoulder dysfunction and 25 age- and gender-matched asymptomatic subjects on two different occasions. Statistical analysis included calculation of intra-class correlation coefficients (ICCs), minimal detectable change (MDC), standard error of measurement (SEM), Pearson correlation coefficient (r), coefficient of determination (R2), and the lower bound score. Mean HBB ROM was 108.6° (SD = 16.3) and 23.9° (SD = 10.5) on the pain-free and symptomatic side, respectively. Both intra-rater and inter-rater reliability were high (ICC > 0.80). For asymptomatic people the SEM was at most 3° and MDC was 8° with a strong correlation between the dominant and nondominant sides (r > 0.72). The mean absolute values and lower bound scores were at most 10.2° and 26.0°, respectively. These results indicate that this new and novel method of measuring HBB ROM is accurate, has good inter- and intra-rater reliability, and provides normal values for between-limb ROM variability.