Observation and measurement of the static position of the scapula is important for investigating both shoulder and neck pathology, which are the second and the third most common sites of musculoskeletal pain. Many techniques and tools have been reported for measuring scapular position. However, these techniques/tools are limited to measuring only one of the scapular static positions, or have limited clinical use because they are expensive, time consuming or lack sufficient rigor in their measurement properties. Therefore, research is required to determine a reliable and accurate method of measuring scapular elevation and depression position. The protractor method could be a useful tool in measuring elevation and depression of the scapula, both clinically and in future research.
This thesis tested the reliability of protractor method in measuring the scapular position using the T8 and C7 method. 35 subjects were tested by two physical therapists, both are not informed of the landmark used by the other. The researchers opted to use the inter-rater reliability in assessing the reliability of the protractor method.
The statistical data showed that for the T8 method, the protractor method is not reliable in measuring the scapular position as it yields low reproducibility in measurements obtained, additionally, the distances recorded by both tester 1 and tester 2 are more dispersed away from the mean. However, for the C7 method, the protractor yielded relatively the same result considering a standard landmark, the intra-class correlation coefficient also showed a result near 1.0, indicating high similarities between measurements taken that method.
The researchers recommend further studies to check if other factors may have contributed in the difference in measurements of Tester 1 and Tester 2. The researchers further recommend a more in-depth study if a measurable pathological threshold value actually exists for scapular elevation or depression as this threshold can be be an effective standard of comparison for values or measurements obtained.
In conclusion, the researchers found the protractor method a reliable way of measuring the scapular position at C7 method for left and right process. C7 is more prominent, making it easier for palpation and landmark identification. The protractor is reliable even in bony prominence provided that it is at C7 method.