Execution
- 1Position the patient standing with the back exposed and observe from behind.
- 2Ask the patient to perform repeated bilateral arm elevation in the scapular plane, then repeated bilateral abduction, using a controlled speed.
- 3Observe both the raising and lowering phases for winging, dysrhythmia, and asymmetrical scapular control.
- 4Classify the pattern as type I inferior-angle prominence, type II medial-border prominence, type III excessive superior-border elevation / early shrugging, or type IV symmetrical normal motion.
- 5Document the dominant pattern and whether it changes with fatigue, load, symptoms, or manual scapular correction.
Positive outcome
Types I, II, and III are positive for scapular dyskinesis patterns. Type I shows inferior-angle prominence, type II shows medial-border prominence, and type III shows excessive superior-border elevation or early scapular elevation during movement. Type IV indicates symmetrical scapular motion without obvious dyskinesis.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Kibler et al. (2002) | intrarater κ = 0.5; interrater κ = 0.4 | NA | NA | NA | NA |
| Uhl et al. (2009) | NA | NA | NA | NA | NA |
CommentThe Kibler system is a descriptive classification of abnormal scapular motion, not a diagnostic test for the source of shoulder pain. Reliability is only moderate, and later work has often favoured a simpler yes / no dyskinesis judgement over forcing a type. Use the classification to communicate the movement pattern and guide impairment reasoning, not to claim a structural diagnosis.
Low Clinical Value