Clarifying acromial distance: Standardisation and association between supine and sitting positions.

OBJECTIVES: To define a standardised acromial distance (AD) in relaxed, supine position and its cut-point with sensitivity and specificity for classifying pectoralis minor (PMI) shortness. To clarify a predictive value of AD while relaxed, supine (AD2) from AD while sitting (AD1), adjusted by the effect of body mass index (BMI). DESIGN: Cross-sectional; SETTING: Laboratory of Physical Therapy Faculties. PARTICIPANTS: Eighty-five participants aged 18-38 years. MAIN OUTCOME MEASURES: A standardised-AD was proportionate of AD at scapular retraction (AD3) to AD2. AD1 was clarified as a predictive variable for AD2 in circumstances of adjusted BMI. RESULTS: The cut-point of standardised-AD for PMI shortness was equal to or above 0.61. The sensitivity and specificity were 75.64% and 85.71%. AD2 was 0.355 time of AD1 when adjusted for effect of BMI. This cumulative effect may be able to explain AD2 for 41.4% of the variation in the AD1 and BMI around its mean. CONCLUSIONS: Standardised-AD may be suitable to reflect PMI shortness while supine. Application for clinical practise may estimate AD2 from AD1 by summation of the effect of BMI. When designing postural education for correcting PMI shortness while lying, efficacy may be a concern in transfer to upright or functional position.

Change of pectoralis minor length, and acromial distance, during scapular retraction at 60° shoulder elevation.

As the pectoralis minor muscle is inserted into the coracoid process, an improper length of this muscle would affect scapular and shoulder motions. Therefore, this study is proposed to assess the effects on pectoralis minor's length and acromial distance after active scapular retraction in scaption at 60° elevation. Sixty right-hand-dominant participants (11 males, 49 females) were randomized into an intervention group and a control group. The intervention group performed pectoralis minor muscle stretching by active scapular retraction, while the control group were asked to sit in an upright position. The result shows that, the mean lengths of pectoralis minor in the intervention group were significantly increased when compared with those of the control group (p = 0.004 and p = 0.014 respectively). Simultaneously, the reduction in acromial distance of this intervention group was substantially greater than the control group's (p < 0.001 and p = 0.001 respectively). However, it should be noted that the results reported only relate to the period immediately following muscle stretching.

Reliability and validity of the Balance Evaluation Systems Test (BESTest) in people with subacute stroke.

BACKGROUND: The Balance Evaluation Systems Test (BESTest) is a new clinical balance assessment tool, but it has never been validated in patients with subacute stroke. OBJECTIVE: The purpose of this study was to examine the reliability and validity of the BESTest in patients with subacute stroke. DESIGN: This was an observational reliability and validity study. METHODS: Twelve patients participated in the interrater and intrarater reliability study. Convergent validity was investigated in 70 patients using the Berg Balance Scale (BBS), Postural Assessment Scale for Stroke (PASS), Community Balance and Mobility Scale (CB&M), and Mini-BESTest. The receiver operating characteristic curve was used to calculate the sensitivity, specificity, and accuracy of the BESTest, Mini-BESTest, and BBS in classifying participants into low functional ability (LFA) and high functional ability (HFA) groups based on Fugl-Meyer Assessment motor subscale scores. RESULTS: The BESTest showed excellent intrarater reliability and interrater reliability (intraclass correlation coefficient=.99) and was highly correlated with the BBS (Spearman r=.96), PASS (r=.96), CB&M (r=.91), and Mini-BESTest (r=.96), indicating excellent convergent validity. No floor or ceiling effects were observed with the BESTest. In contrast, the Mini-BESTest and CB&M had a floor effect in the LFA group, and the BBS and PASS demonstrated responsive ceiling effects in the HFA group. In addition, the BESTest showed high accuracy as the BBS and Mini-BESTest in separating participants into HFA and LFA groups. LIMITATION: Whether the results are generalizable to patients with chronic stroke is unknown. CONCLUSION: The BESTest is reliable, valid, sensitive, and specific in assessing balance in people with subacute stroke across all levels of functional disability.