The Reliability and Validity of a Novel Clinical Test for Assessing Shoulder Rotation ROM in Collegiate Baseball Players: Functional Assessment of System Tension of the Shoulder (FAST-SHDR).

Abstract

Background: Traditional methods to measure rotational passive range of motion (PROM) in the throwing shoulder do not reflect the complexity of the throwing motion. Therefore, a sport specific shoulder rotation PROM test (FAST-SHDR) was developed and compared to traditional standard methods to measure shoulder internal and external rotational PROM in the throwing shoulder.

Purpose: The aim of this study was to determine the intra-rater reliability of the FAST-SHDR test in young, healthy, male Division 1 baseball players.

Study design: Reliability and validity analysis.

Methods: A study with 49 healthy participants (31 collegiate baseball players, 18 controls) examined a sport specific shoulder rotation PROM test (FAST-SHDR) and compared this to the standard supine 90/90 shoulder in a single session assessment. Intra-class correlation coefficient (ICC), standard error of measurement (SEM) and minimum detectable change (MDC) were calculated. Within and between group differences were based on t-tests (p<0.001), absolute differences and effect sizes (95% CIs).

Results: The novel test (FAST-SHDR) had good to excellent reliability with ICCs ranging from 0.95 (0.89 to 0.98) to 0.96 (0.92-0.98). MDC ranged from 7°-11° which is equivalent to 11-14% of mean PROM scores. In the dominant shoulder of baseballers, when FAST-SHDR IR/ER was compared to standard IR/ER testing the FAST-SHDR scores were lower for both IR (MD 23.3°; 95% CI 19.7-26.8) and ER (MD 50.7°; 95% 44.7 to 56.7). Comparing the shoulder rotation PROM in baseballers, the FAST-SHDR ER and IR measurements were significantly lower (p<0.0001) when compared to traditional standard PROM testing for shoulder IR and ER rotation.

Conclusions: FAST-SHDR testing shows good to excellent intra-rater reliability for measuring shoulder rotational PROM and demonstrates both face and discriminant validity.

Level of evidence: 3.