The Reliability and Validity of a Clinical Measurement Proposed to Quantify Humeral Torsion.
Paul A Salamh, William J Hanney, Lauren Champion and 4 others
PMID 34980996WHAT IT FOUND
Palpating the biceps forearm angle was consistent when the same clinician repeated it, but it correlated only moderately with ultrasound and showed wide disagreement in individual values.
Use it for side-to-side comparisons only when imaging is unavailable.
Key findings
01The palpation method showed good intrarater reliability (ICC = 0.849) with a standard error of measurement of 5 degrees.
02Convergent validity with diagnostic ultrasound was supported by a moderate correlation (r = 0.566).
03The 95% limits of agreement between the two methods were wide (-24.80° and 19.80°), indicating potential for significant overestimation or underestimation of humeral torsion.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample consisted of healthy college-aged adults, which may not represent the population of overhead athletes with shoulder pain. Interrater reliability was not assessed, so it is unknown how consistent the measurements would be between different clinicians. The student performing the palpation measurements had limited experience with the technique, which may have influenced the validity results. The wide limits of agreement suggest that the palpation method may not be interchangeable with ultrasound for individual patients.
The easy way to misread this
Do not interpret the moderate correlation as evidence that palpation accurately measures humeral torsion in an individual patient. The wide limits of agreement (-24.80° to 19.80°) mean the palpation method can significantly overestimate or underestimate the true angle compared to ultrasound.