This study compared two ways of visually grading scapular dyskinesis: the 4-type Kibler classification and a simplified yes/no method. Both were validated against 3D electromagnetic kinematic analysis in 56 subjects (35 with shoulder injury, 21 controls). It asks which observational method is more reliable and accurate for everyday clinical use.
When you screen a painful shoulder for scapular dyskinesis, just decide present or absent rather than sorting it into a Kibler type. This yes/no call is more reproducible between examiners (79% vs 61%) and more sensitive (76%), because real dyskinesis almost always spans multiple planes and the 4-type system forces you to pick just one.
Test in forward flexion, not scaption. Multiple-plane asymmetry separated symptomatic from asymptomatic shoulders only in flexion (54% vs 14%), likely reflecting the serratus anterior bias of that motion.
Remember that asymmetry alone is common and non-specific: 71% to 77% of all shoulders, symptomatic or not, show some asymmetry. Think of it like a sulcus sign or patellofemoral malposition, a finding to weigh in context, not a diagnosis. Use the test to rule dyskinesis in or out as a contributor to pain, then let a positive finding help direct rehab.
This study compared two ways of visually grading scapular dyskinesis: the 4-type Kibler classification and a simplified yes/no method. Both were validated against 3D electromagnetic kinematic analysis in 56 subjects (35 with shoulder injury, 21 controls). It asks which observational method is more reliable and accurate for everyday clinical use.
When you screen a painful shoulder for scapular dyskinesis, just decide present or absent rather than sorting it into a Kibler type. This yes/no call is more reproducible between examiners (79% vs 61%) and more sensitive (76%), because real dyskinesis almost always spans multiple planes and the 4-type system forces you to pick just one.
Test in forward flexion, not scaption. Multiple-plane asymmetry separated symptomatic from asymptomatic shoulders only in flexion (54% vs 14%), likely reflecting the serratus anterior bias of that motion.
Remember that asymmetry alone is common and non-specific: 71% to 77% of all shoulders, symptomatic or not, show some asymmetry. Think of it like a sulcus sign or patellofemoral malposition, a finding to weigh in context, not a diagnosis. Use the test to rule dyskinesis in or out as a contributor to pain, then let a positive finding help direct rehab.