Reliability of freehand three-dimensional ultrasound to measure scapular rotations

Lynn A. Worobey, Ima A. Udofa, Yen Sheng Lin, Alicia M. Koontz, Shawn S. Farrokhi, Michael L. Boninger*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


The objective of this study was to evaluate the reliability of using freehand three-dimensional ultrasound to measure scapular rotations (internal/external, upward/downward, anterior/posterior). The scapular position in 22 healthy, nondisabled individuals was imaged three times in four testing positions of interest (arm at rest and humeral elevation in the sagittal, frontal, and scapular planes). We found substantial reliability across scanning positions and scapular rotations, with intraclass correlation coefficients ranging from 0.62 to 0.95. The highest reliability was found in the rest testing position. Our standard error of measurement was less than 2 degrees for all measurements and less than 0.5 degrees for most. Minimum detectable change ranged from 0.37 to 3.08 degrees. Our results agree with the pattern of movement found in other studies, with the scapula moving toward a more externally rotated, upwardly rotated, and posteriorly tilted position with humeral elevation. Further study is warranted to compare our methods to a gold standard, apply them to evaluation of dynamic movement, and determine whether they can be used to detect shoulder pathology.

Original languageEnglish
Pages (from-to)985-994
Number of pages10
JournalJournal of Rehabilitation Research and Development
Issue number6
StatePublished - 2014
Externally publishedYes


  • Anterior/posterior tilting
  • Freehand ultrasound
  • Humeral elevation
  • Internal/external rotation
  • Minimum detectable change
  • Reliability
  • Rotation
  • Scapula
  • Standard error of measurement
  • Upward/downward rotation


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