Lumbar Locked Thoracic Rotation Procedure, Reliability and Normative Data

thoracic rotation

When considering which specific tests we would perform after movement screening, both ankle dorsiflexion and thorax (or thoracic) mobility would be at the top of our list (particularly in the overhead athlete). Performing this test gives invaluable information and it has proven to be reliable but just as with any test, it must done correctly. This article is designed to go through the specific testing procedure for the lumbar locked thoracic rotation tests as well as examine the literature regarding its reliability, minimimal dectable change (MDC), and standard error of the measure (SEM).

Let's start with an example of applying this test to a baseball player and how it affects performance. Having good rotational mobility in the thoracic spine is essential as it provides the opportunity for the overhead thrower to use the elastic energy created from the separation of the hips and shoulders. The ability to produce hip shoulder separation has been moderately correlated (0.39, p=0.027) to increased trunk rotation velocity and faster trunk rotation is associated with greater pitching velocity (0.478, p=0.006) (Bullock et al 2020, Sgroi et al 2015)

Thoracic mobility alone isn't always enough though, as overhead throwers must be able to properly sequence the trunk rotation and control the mobility they possess (Scarborough et al 2020). So, once you have good motion in the thoracic spine, next train your thrower to control it in order to optimize their potential. Now that we have an example of its importance in baseball, we need to look at how to perform the Lumbar Locked Thoracic Rotation correctly.

Lumbar Locked Thoracic Rotation Procedure

The person is placed in quadruped and instructed to sit with his hips back on his heels to maximally flex the hips. Upper extremities are positioned with elbows flexed and forearms together resting on a treatment table.
The person places one upper extremity behind his back in the lower lumbar region. While stabilizing the ipsilateral hips and torso, the second examiner grasps the contralateral anterior shoulder of the person and passively rotates the thoracic spine until first resistance is achieved. The examiner monitors for compensations such as excessive spinal sidebending, weight shifting, or inability of the hips to remain on the heels. The person is encouraged to actively rotate his neck in sync with the passive thoracic rotation.
One examiner places a phone inclinometer between the spinous processes of T1,2 and records the rotation ROM in degrees.
After the measurement is recorded, the player's arm is returned to the starting position and the test is repeated for a second measurement.
The entire test shoulder flexion procedure is repeated on the opposite side.

Lumbar Locked Thoracic RotationTest Reliability

Lumbar Locked Thoracic Rotation Normative Data

What is the Minimal Detectable Change (MDC) of the Lumbar Locked Thoracic Rotation test?

The MDC of the Lumbar Locked Thoracic Rotation test in competitive swimmers ages 10-18 is 12.2° (Feijen et al 2018).

The MDC of the Lumbar Locked Thoracic Rotation test in healthy adults age 23.6 +/- 4.2 years is 5.5° (Johnson et al 2012).

What is the Standard Error of Measurement (SEM) of the Lumbar Locked Thoracic Rotation Test?

The SEM of the Lumbar Locked Thoracic Rotation test in competitive swimmers ages 10-18 years old is 4.41° (Feijen et al 2018).

The SEM of the Lumbar Locked Thoracic Rotation test in healthy adults aged 30.8 ± 11.0 years old for L thoracic rotation measured with an inclinometer is 1.91° within the session and 3.04° between sessions. For R thoracic rotation measured with an inclinometer, it is 3.38° within the session and 2.94° between sessions. The SEM for Total ROM measured with an inclinometer is 3.72° within the session and 5.37° between sessions (Furness et al 2016).

The SEM of the Lumbar Locked Thoracic Rotation ROM test in University-aged students ages 29.8 ± 8.9 measured with a Universal Goniometer is 6.33° to the R and 7.85° to the L. With the iPhone compass application, the SEM is 5.46° to the R and 5.17° to the L. (Furness et al 2018)

The SEM of the Lumbar Locked Thoracic Rotation test in healthy adults age 23.6 ± 4.2 years is 2.25° to the R and 2.00° to the L within the same session and intertester. The MDC of the Lumbar Locked Thoracic Rotation test between days intratester is 5° (Johnson et al 2012).

References

Bullock GS, Strahm J, Hulburt TC, Beck EC, Waterman BR, Nicholson KF. THE RELATIONSHIP OF RANGE OF MOTION, HIP SHOULDER SEPARATION, AND PITCHING KINEMATICS. Int J Sports Phys Ther. Dec 2020;15(6):1119-1128. doi:10.26603/ijspt20201119

Feijen S, Kuppens K, Tate A, Baert I, Struyf T, Struyf F. Intra- and interrater reliability of the 'lumbar-locked thoracic rotation test' in competitive swimmers ages 10 through 18 years. Phys Ther Sport. 2018;32:140-144. doi:10.1016/j.ptsp.2018.04.012

Furness J, Schram B, Cox AJ, Anderson SL, Keogh J. Reliability and concurrent validity of the iPhone^® Compass application to measure thoracic rotation range of motion (ROM) in healthy participants. PeerJ. 2018;6:e4431. Published 2018 Mar 8. doi:10.7717/peerj.4431

Furness J, Climstein M, Sheppard JM, Abbott A, Hing W. Clinical methods to quantify trunk mobility in an elite male surfing population. Phys Ther Sport. 2016;19:28-35. doi:10.1016/j.ptsp.2015.09.003

Johnson KD, Kim KM, Yu BK, Saliba SA, Grindstaff TL. Reliability of thoracic spine rotation range-of-motion measurements in healthy adults. J Athl Train. 2012;47(1):52-60. doi:10.4085/1062-6050-47.1.52

Scarborough DM, Bassett AJ, Mayer LW, Berkson EM. Kinematic sequence patterns in the overhead baseball pitch. Sports biomechanics. Oct 2020;19(5):569-586. doi:10.1080/14763141.2018.1503321

Sgroi T, Chalmers PN, Riff AJ, et al. Predictors of throwing velocity in youth and adolescent pitchers. Journal of shoulder and elbow surgery. Sep 2015;24(9):1339-45. doi:10.1016/j.jse.2015.02.015

About the Contributors

Kyle Matsel PT, DPT, PhD, SCS, CSCS
Enriching the profession of rehabilitation and wellness has always been a passion of Kyle's.
In addition to being a clinician, he is an Associate Professor of Physical Therapy at the University
of Evansville and the Director of the ProRehab and University of Evansville Sports Residency
Program. The opportunity to work with so many great professionals has constantly challenged
Kyle to continue to grow professionally and personally. As a result, he obtained his PhD from the
University of Kentucky where he studied the identification of musculoskeletal injury risk factors
and implementation of arm care exercise programs in baseball players. These experiences have
provided him with insights into injury factor management to reimagine the idea of
musculoskeletal healthcare and wellness.

Tessa Netelbeek, PT, DPT, SCS, CSCS
Tessa is a sports physical therapist who is passionate about helping people return to what they love to do. She obtained her physical therapy degree from the University of Montana and then completed a sports physical therapy residency program at the University of Evansville & ProRehab. She is also a certified strength and conditioning specialist and is certified in Functional Movement Systems. Her strengths include return-to-sport testing and rehabilitation, movement assessment, and injury prevention training and education.

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