Kibler et al. tested whether a new 4-pattern visual system for classifying scapular dyskinesis could be applied reliably by blinded clinicians. 4 evaluators (2 physicians, 2 physical therapists) categorized scapular movement patterns in 26 subjects from standardized videotape. The goal was to establish a common clinical language for dynamic scapular dysfunction associated with shoulder injury.
Every shoulder exam includes watching scapular motion, but before this paper there was no standardized language to describe what you were seeing. Terms like "winging" and "tilting" were used interchangeably, and no system existed to communicate findings consistently between providers.
This paper gives you a 4-type framework you can apply in clinic today. Stand behind the patient during bilateral arm elevation and lowering. Look for which border becomes prominent: inferior angle (Type I), full medial border (Type II), or superior border with shrugging (Type III). No border prominence means Type IV (normal).
Because patterns are more visible on the way down, always watch the descent phase. If you see a mixed pattern, the Type I component on lowering is what you should document as predominant.
The kappa values (0.31 to 0.59) are honest about the system's limits. Use it as a clinical communication tool to guide rehabilitation targeting, not as a definitive diagnostic label — the authors themselves say it does not constitute a classification system as currently developed.
Kibler et al. tested whether a new 4-pattern visual system for classifying scapular dyskinesis could be applied reliably by blinded clinicians. 4 evaluators (2 physicians, 2 physical therapists) categorized scapular movement patterns in 26 subjects from standardized videotape. The goal was to establish a common clinical language for dynamic scapular dysfunction associated with shoulder injury.
Every shoulder exam includes watching scapular motion, but before this paper there was no standardized language to describe what you were seeing. Terms like "winging" and "tilting" were used interchangeably, and no system existed to communicate findings consistently between providers.
This paper gives you a 4-type framework you can apply in clinic today. Stand behind the patient during bilateral arm elevation and lowering. Look for which border becomes prominent: inferior angle (Type I), full medial border (Type II), or superior border with shrugging (Type III). No border prominence means Type IV (normal).
Because patterns are more visible on the way down, always watch the descent phase. If you see a mixed pattern, the Type I component on lowering is what you should document as predominant.
The kappa values (0.31 to 0.59) are honest about the system's limits. Use it as a clinical communication tool to guide rehabilitation targeting, not as a definitive diagnostic label — the authors themselves say it does not constitute a classification system as currently developed.