INVESTIGATION OF THE VALIDITY AND RELIABILITY OF 4 OBJECTIVE TECHNIQUES FOR MEASURING FORWARD SHOULDER POSTURE

Clinicians often rely on visual inspection and descriptive terms to do cument a patient's forward shoulder posture. The purpose oi this study was to assess the validity and intrarater reliability of four objecti ve techniques to measure forward shoulder posture. Subjects were 25 ma les and 24 females. Subjects had a lateral cervical spine radiograph t aken, from which the horizontal distance from the C7 spinous process t o the anterior tip of the left anterior acromion process was measured. Subjects then proceeded twice through a random order oi four measurem ents: the Baylor square, the double square, the Sahrmann technique, an d scapular position. These results were then used to determine the int rarater reliability of each technique. Multiple regression analyses we re performed on each measure's mean scores to determine both the corre lation with and the predictive value for the radiographic measurement. The intraclass correlation coefficients for intrarater reliability ra nged from .89 to .91. The correlation coefficients ranged from -.33 to .77, and the coefficients of determination ranged from .10 to .59 (N= 49). The researchers demonstrated clinical reliability ibr each techni que; however, validity compared with the radiographic measurement coul d not be established. These techniques may have clinical value in obje ctively measuring change in a patient's shoulder posture as a result o i a treatment program. Before any of these measures could be universal ly recommended in clinical practice, future research is necessary to e stablish interrater reliability and assess each technique's ability to detect postural changes over time.