Agreement Between Face-to-Face and Tele-Assessment of Shoulder Function and Clinical Impairment in Female Handball Players with Previous Shoulder Injury
Source abstract
Abstract
Background: Shoulder injuries are highly prevalent in handball due to repetitive overhead actions and high mechanical demands, particularly in athletes with a history of previous injury who remain at increased risk of recurrence. Reliable monitoring of shoulder function is essential, and tele-assessment has emerged as a potential alternative to traditional face-to-face evaluation. The aim of this study was to evaluate the level of agreement between face-to-face and tele-assessment methods for measuring shoulder range of motion, dynamic stability, muscular endurance, and scapular dyskinesia in female handball players with a history of shoulder injury. Methods: A cross-sectional agreement study was conducted in 25 competitive female handball players with a history of shoulder injury. Each participant underwent two evaluations (face-to-face and videoconference-based) performed by experienced physiotherapists in randomized order within the same session. Outcomes included shoulder range of motion, dynamic stability assessed by the Upper Quarter Y Balance Test, muscular endurance, and scapular dyskinesia. Agreement between methods was analyzed using two-way random-effects intraclass correlation coefficients. Results: Excellent agreement was observed for range of motion, dynamic stability, and muscular endurance (ICC = 0.96–1.00), with narrow confidence intervals. Scapular dyskinesia demonstrated good agreement (Cohen’s Kappa coefficient 0.59 (p < 0.05)). Mean differences between face-to-face and tele-assessment were minimal, ranging from 0.04° to 0.31° for ROM and 0.10 cm to 0.16 cm for stability measures. Conclusions: Tele-assessment provides clinically comparable results to in-person evaluation and may represent a feasible and reliable tool for remote monitoring of shoulder function in female overhead athletes with a history of injury.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Shoulder Injury and Treatment · Sports injuries and prevention · Knee injuries and reconstruction techniques
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Department of Physiotherapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
References (44)
Show source-provided references
1. Shoulder injuries from birth to old age: A 1-year prospective study of 3031 shoulder injuries in an urban population10.1016/j.injury.2018.05.013 ↗
2. Incidence, prevalence, and consultation rates of shoulder complaints in general practice10.3109/03009742.2011.605390 ↗
3. High prevalence of shoulder pain among elite Norwegian female handball players10.1111/j.1600-0838.2011.01398.x ↗
4. The influence of glenohumeral joint posterior capsule tightness and impingement symptoms on shoulder impairments and kinematics10.1093/ptj/pzz052 ↗
5. Scapular dyskinesis and its relation to shoulder injury10.5435/JAAOS-20-06-364 ↗
6. Bilateral shoulder proprioception deficit in unilateral anterior shoulder instability10.1016/j.jse.2018.08.034 ↗
7. Reduced glenohumeral rotation, external rotation weakness and scapular dyskinesis are risk factors for shoulder injuries among elite male handball players: A prospective cohort study10.1136/bjsports-2014-093702 ↗
8. Preseason shoulder range of motion screening as a predictor of injury among youth and adolescent baseball pitchers10.1016/j.jse.2015.03.012 ↗
9. Prevention of shoulder injuries in overhead athletes: A science-based approach10.1590/bjpt-rbf.2014.0109 ↗
10. Scapular dyskinesis is not an isolated risk factor for shoulder injury in athletes: A systematic review and meta-analysis10.1177/0363546520968508 ↗
11. Handball load and shoulder injury rate: A 31-week cohort study of 679 elite youth handball players10.1136/bjsports-2016-096927 ↗
12. Potentials of digitalization in sports medicine: A narrative review10.1249/JSR.0000000000000704 ↗
13. Electronic, mobile and telehealth tools for vulnerable patients with chronic disease: A systematic review and realist synthesis10.1136/bmjopen-2017-019192 ↗
14. Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: A systematic review and meta-analysis10.1177/0269215516645148 ↗
15. Validity and reliability of internet-based physiotherapy assessment for musculoskeletal disorders: A systematic review10.1177/1357633X16642369 ↗
16. Telemedicine in hand and upper-extremity surgery10.1016/j.jhsa.2019.09.007 ↗
17. The virtual shoulder physical exam10.1177/1556331620975033 ↗
18. Statistical methods for assessing agreement between two methods of clinical measurement10.1016/S0140-6736(86)90837-8 ↗
19. Guidelines for Reporting Reliability and Agreement Studies (GRRAS) were proposed10.1016/j.jclinepi.2010.03.002 ↗
20. Puig-Diví, A., Escalona-Marfil, C., Padullés-Riu, J.M., Busquets, A., Padullés-Chando, X., and Marcos-Ruiz, D. (2019). Validity and reliability of the Kinovea program in obtaining angles and distances using coordinates in 4 perspectives. PLoS ONE, 14.10.1371/journal.pone.0216448 ↗
21. The reliability and concurrent validity of shoulder mobility measurements using a digital inclinometer and goniometer: A technical report
22. Use of videoconferencing for physical therapy in people with musculoskeletal conditions: A systematic review10.1177/1357633X17700781 ↗
23. The disabled throwing shoulder: Spectrum of pathology Part I: Pathoanatomy and biomechanics10.1053/jars.2003.50128 ↗
24. Versión española del cuestionario DASH. Adaptación transcultural, fiabilidad, validez y sensibilidad a los cambios10.1157/13093053 ↗
25. Google (2026, February 27). Google Meet. Available online: https://meet.google.com.
26. A clinical method for identifying scapular dyskinesis, part 1: Reliability10.4085/1062-6050-44.2.160 ↗
27. Evaluation of clinical assessment methods for scapular dyskinesis10.1016/j.arthro.2009.06.007 ↗
28. Intra- and inter-rater reliability for limb length measurement and trial error assessment of the upper quarter Y-balance test in healthy adults10.26603/ijspt20190707 ↗
29. Upper quarter Y balance test: Reliability and performance comparison between genders in active adults10.1519/JSC.0b013e3182472fdb ↗
30. Upper extremity exercise training in chronic obstructive pulmonary disease10.1378/chest.93.4.688 ↗
31. Interrater agreement between telerehabilitation and face-to-face clinical outcome measurements for total knee arthroplasty10.1089/tmj.2009.0106 ↗
32. Agreement between telerehabilitation and face-to-face clinical outcome assessments for low back pain in primary care10.1097/BRS.0b013e318281a36c ↗
33. Effectiveness of telerehabilitation in physical therapist practice: An umbrella and mapping review with meta-meta-analysis10.1093/ptj/pzab075 ↗
34. Telerehabilitation mediated physiotherapy assessment of ankle disorders10.1002/pri.471 ↗
35. Inter-rater and intra-rater reliability of Kinovea software for measurement of shoulder range of motion
36. Systematic review and meta-analysis of the Y-balance test lower quarter: Reliability, discriminant validity, and predictive validity10.26603/001c.27634 ↗
37. What risk factors are associated with musculoskeletal injury in US Army Rangers? A prospective prognostic study10.1007/s11999-015-4342-6 ↗
38. Rehabilitation of shoulder impingement syndrome and rotator cuff injuries: An evidence-based review10.1136/bjsm.2009.058875 ↗
39. Improved reporting of overuse injuries and health problems in sport: An update of the Oslo Sport Trauma Research Center questionnaires10.1136/bjsports-2019-101337 ↗
40. Validity and reliability of the assessment and diagnosis of musculoskeletal elbow disorders using telerehabilitation10.1258/jtt.2012.120501 ↗
41. Reliability of assessment methods for scapular dyskinesis in asymptomatic subjects: A systematic review10.5152/j.aott.2020.19088 ↗
42. Shoulder muscle recruitment patterns and related biomechanics during upper extremity sports10.2165/00007256-200939070-00004 ↗
43. Descriptive profile of scapulothoracic position, strength and flexibility variables in adolescent elite tennis players10.1136/bjsm.2009.070128 ↗
44. Evidence of benefit of telerehabitation after orthopedic surgery: A systematic review10.2196/jmir.6836 ↗