Measurement of Active Internal Rotation
The procedure for measuring IR-AROM followed an established protocol.21,25 The procedure has previously
been investigated for intrarater reliability with ICC (3,k) reported at 0.99.21 Participants were positioned
prone, with the tested arm supported on the table at 90 degrees of abduction, elbow flexed to 90
degrees and the wrist in neutral (Figure 3).
A towel roll was placed directly under each participant’s arm to ensure a neutral position of the humerus in the
coronal plane without migration into the transverse plane.
Additionally, the towel roll was used to provide stabilization.
Neutral horizontal positioning of the arm was considered the position where the humerus did not migrate into horizontal adduction or abduction.
Neutral horizontal positioning of the humerus ensured that tension in the posterior soft tissues was minimized.
Additionally, in the prone position, both the towel roll and table serve to potentially limit compensatory scapular anterior tilt and protraction 25 as opposed to the supine position which would require manual stabilization from the investigator.
The effect of scapular stabilization on measurement reproducibility is contradictory as IR measurement procedures without stabilization have been reported to possess both higher and lower levels of reproducibility when compared to procedures stabilizing the shoulder and or scapula.
This investigation did not use any manual stabilization during IR measurements. Participants were asked to rotate
their arm to their maximum available IR without compromising form and verbal cues were provided as necessary.
Although the towel roll was used with an individualized circumference that maintained the humerus in a horizontal neutral, participants were requested to stop movement if they began to exhibit compensatory form and no measurements were recorded with the scapula tilted anteriorly beyond the start position.
Once movement ceased the inclinometer was placed on the distal forearm proximal to the radiocarpal joint and the measurement was recorded.
Five participants were required to repeat the IR measurement once as a result of compromised form.
One participant’s results were excluded from further analysis as a result of compromised form on two repeated occasions during the IR measurement.
Measurement of Active Internal Rotation
The procedure for measuring IR-AROM followed an established protocol.21,25 The procedure has previously
been investigated for intrarater reliability with ICC (3,k) reported at 0.99.21 Participants were positioned
prone, with the tested arm supported on the table at 90 degrees of abduction, elbow flexed to 90
degrees and the wrist in neutral (Figure 3).
A towel roll was placed directly under each participant’s arm to ensure a neutral position of the humerus in the
coronal plane without migration into the transverse plane.
Additionally, the towel roll was used to provide stabilization.
Neutral horizontal positioning of the arm was considered the position where the humerus did not migrate into horizontal adduction or abduction.
Neutral horizontal positioning of the humerus ensured that tension in the posterior soft tissues was minimized.
Additionally, in the prone position, both the towel roll and table serve to potentially limit compensatory scapular anterior tilt and protraction 25 as opposed to the supine position which would require manual stabilization from the investigator.
The effect of scapular stabilization on measurement reproducibility is contradictory as IR measurement procedures without stabilization have been reported to possess both higher and lower levels of reproducibility when compared to procedures stabilizing the shoulder and or scapula.
This investigation did not use any manual stabilization during IR measurements. Participants were asked to rotate
their arm to their maximum available IR without compromising form and verbal cues were provided as necessary.
Although the towel roll was used with an individualized circumference that maintained the humerus in a horizontal neutral, participants were requested to stop movement if they began to exhibit compensatory form and no measurements were recorded with the scapula tilted anteriorly beyond the start position.
Once movement ceased the inclinometer was placed on the distal forearm proximal to the radiocarpal joint and the measurement was recorded.
Five participants were required to repeat the IR measurement once as a result of compromised form.
One participant’s results were excluded from further analysis as a result of compromised form on two repeated occasions during the IR measurement.
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