journal article·2026-04-16Open access

Agreement Between Face-to-Face and Tele-Assessment of Shoulder Function and Clinical Impairment in Female Handball Players with Previous Shoulder Injury

Javier Martín Núñez, Andrés Calvache Mateo, Laura López López, Rafael Jiménez López, Jiawi André Guo Liang, Marie Carmen Valenza, María del Carmen García Ríos

Applied Sciences· Volume 16· Issue 8

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 ↗