MEASUREMENT OF THE CLAVICLE KINEMATICS: A SYSTEMATIC REVIEW

C.K. Tang¹, Y.F. Shih¹

¹National Yang Ming Chiao Tung University, Department of Physical Therapy and Assistive Technology, Taipei, Taiwan

Background: The acromioclavicular (AC) joint and sternoclavicular (SC) joint are parts of the shoulder complex, and contribute to the scapulothoracic (ST) movement. Measurement of the clavicle kinematics has been described using the electromagnetic systems, optoelectronic systems, or image studies. However, there has been no consensus regarding the methodology or the results of the clavicle kinematic measurements.

Purpose: The aim of this review is to summarize and qualitatively compare the characteristics of different measurement methods for assessing clavicle kinematics.

Methods: The study recruited publications describing clavicle movement during shoulder elevation, flexion, or abduction. We identified 354 articles by database search, and 3 from cross reference search. After removing duplicates, 223 articles were screened for titles and abstracts, and 180 were excluded. The remaining 43 pieces were through the full-text articles assessed, 27 were excluded, and 16 articles were included in this systematic review.

Results: There are nine studies used the electromagnetic systems to record clavicle movement (surface sensors (SS): 4, bony sensors (BS): 5). These studies generally found the clavicle retracted, elevated and posteriorly rotated during shoulder abduction. When tested in humeral flexion, the clavicle only started retraction later (after 90-100^o). Use of SS resulted in larger variabilities for clavicular retraction (SS: 3.5^o to 11.5^o, BS: 16^o to 17^o) and elevation (SS: -2^o to 10.6^o, BS: 6.5^o to 11^o), and a larger clavicle posterior rotation (SS: 30.8^o, BS: 23.5^o to 25^o). Variations in data might arise from skin movement and the size of the SS. Three studies used the optoelectronic system to describe clavicle kinematics, two used acromial clusters (with and without clavicle marker) and one used bony sensors. The bone pin study found 27^o and 13^o of clavicle retraction and elevation, similar to the data obtained using the electromagnetic system. Studies used acromial cluster, like those with SS, also showed a bigger variation in data (retraction: 10^o to 27.5^o, elevation: 10^o to 15^o, posterior rotation: 5.5^o to 13^o). Four imaging studies described clavicle movement: two using open magnetic resonance imaging (MRI), one computer tomography (CT), and one fluoroscopic image. While fluoroscopy found similar clavicle movement (retraction: 15^o, elevation: 17^o), data from CT and MRI were not comparable to those from other studies due to variations in methods of movement description.

Conclusions: The electromagnetic tracking system was the most common method for assessing clavicular kinematics. Use of bony sensors resulted in more accurate kinematic measurement, while surface sensors are more feasible and the accuracy might be improved with the use of mini sensors.

Implications: Assessing clavicle movement is an important part of understanding the shoulder motion. The way to improve the accuracy of measuring the clavicle kinematics should be addressed.

Funding acknowledgements: There was not any funding acknowledgement to state.

Keywords:
Clavicle kinematics
Shoulder kinematics

Topics:
Musculoskeletal: upper limb
Research methodology, knowledge translation & implementation science

Did this work require ethics approval? No

Reason: We submit a systematic review.