Journal of Biomechanics ()

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Journal of Biomechanics
journal homepage: www.elsevier.com/locate/jbiomech
www.JBiomech.com

3D shoulder kinematics for static vs dynamic and passive vs active

testing conditions
Xavier Robert-Lachaine a,n, Paul Allard a,b,c, Vronique Godbout d, Mickael Begon a,b,c
a
Dpartement de Kinsiologie, Universit de Montral, Montral, Canada
b
Hpital Sainte-Justine, CHUM, Montral, Canada
c
Scapulo Humeral Investigation Team
d
Hpital Notre-Dame, CHUM, Montral, Canada

art ic l e i nf o a b s t r a c t

Article history: Shoulder motion analysis provides clinicians with references of normal joint rotations. Shoulder joints
Accepted 30 July 2015 orientations assessment is often based on series of static positions, while clinicians perform either
passive or active tests and exercises mostly in dynamic. These conditions of motion could modify joint
coordination and lead to discrepancies with the established references. Hence, the objective was to
Keywords: evaluate the inuence of static vs dynamic and passive vs active testing conditions on shoulder joints
Shoulder orientations. Twenty asymptomatic subjects setup with 45 markers on the upper limb and trunk were
Static tracked by an optoelectronic system. Static positions (30, 60, 90 and 120 of thoracohumeral elevation)
Dynamic
and dynamic motion both in active condition and passively mobilised by an examiner were executed.
Passive
Three-dimensional sternoclavicular, acromioclavicular, scapulothoracic and glenohumeral joint angles
Active
Motion analysis (12 in total) representing the distal segment orientation relative to the proximal segment orientation
were estimated using a shoulder kinematical chain model. Separate four-way repeated measures ANOVA
were applied on the 12 joint angles with factors of static vs dynamic, passive vs active, thoracohumeral
elevation angle (30, 60, 90 and 120) and plane of elevation (frontal and sagittal). Scapulothoracic
lateral rotation progressed more during arm elevation in static than in dynamic gaining 4.2 more, and
also in passive than in active by 6.6. Glenohumeral elevation increased more during arm elevation in
active than in passive by 4.4. Shoulder joints orientations are affected by the testing conditions, which
should be taken into consideration for data acquisition, inter-study comparison or clinical applications.
& 2015 Elsevier Ltd. All rights reserved.

1. Introduction dynamic vs static and passive vs active conditions on healthy sub-

Shoulder motion analyses serve both to establish normal joint
rotations and identify pathologic patterns (Fayad et al., 2006; Lude-
wig et al., 2004). During the examination of a patient reporting
shoulder pain, shoulder joints orientations are estimated visually or
with a manual goniometer (Montgomery and Suri, 2011). The man-
ual goniometer is adjusted according to anatomical landmarks dur-
ing static positions. Since dynamic motion represents a target of most
rehabilitation programs (Montgomery and Suri, 2011), a dichotomy
may occur when clinical guidelines are based on static positions. In
addition, clinicians often rely on passive tests or exercises during
physical examination (Price et al., 2000). To identify abnormal
shoulder behaviour it seems important to understand the effect of
n
Corresponding author at: Laboratoire de Simulation et Modlisation du Mou-
vement, Dpartement de Kinsiologie, Universit de Montral, Campus Laval, 1700
Jacques-Ttreault, H7N 0B6, Laval, Qubec, Canada. Tel.: 1 514 343 6111x44017; fax:
1 514 343 2181.
E-mail address: xavier.robert-lachaine@umontreal.ca (X. Robert-Lachaine).
jects. Shoulder motion analyses could mislead clinicians if testing
conditions are ignored.
Clinicians and scientists deal with the same limitation that non-
invasive assessment of shoulder motion is affected by skin motion
artefacts over bones (Karduna et al., 2001; Meskers et al., 2007). For
this reason, researchers have developed tools and methods like the
scapula locator or the double calibration based on a few selected
static positions to estimate the full range of motion (Brochard et al.,
2011; Johnson et al., 1993; Pronk and van der Helm, 1991). These
latter methods identify the scapula coordinate system at each static
position according to the palpated anatomical landmarks. However,
these static approaches were not validated on dynamic testing con-
ditions or other type of arm motion. In addition, the difference
between each palpation for every static position introduces reliability
issues (Della Croce et al., 2005). Furthermore, they are limited to the
scapula, while the clavicle and humerus are also confronted to soft
tissue artefacts. Alternative methods exist to measure shoulder
motion dynamically without several static acquisitions (Jackson et al.,

http://dx.doi.org/10.1016/j.jbiomech.2015.07.040
0021-9290/& 2015 Elsevier Ltd. All rights reserved.

Please cite this article as: Robert-Lachaine, X., et al., 3D shoulder kinematics for static vs dynamic and passive vs active testing
conditions. Journal of Biomechanics (2015), http://dx.doi.org/10.1016/j.jbiomech.2015.07.040i
2 X. Robert-Lachaine et al. / Journal of Biomechanics ()

2012; Karduna et al., 2001); these approaches can indicate the
impact of testing conditions on shoulder kinematics.
Shoulder kinematics compared between series of static positions
and dynamic testing conditions have revealed signicant differences
(Fayad et al., 2006; Meskers et al., 2007). Kinematics at various arm
motion velocities also suggest that static positions may differ from
dynamic motion (Prinold et al., 2013). The assumption that static
positions represent adequately dynamic motion (Brochard et al., 2011;
Lovern et al., 2009) was not thoroughly tested and needs further
investigation on shoulder joints orientations. When comparing the
methods of skin markers during dynamic motion to the scapula locator
during static positions, a study attributed the joint angle difference to
the inaccuracy of the skin markers method (Lovern et al., 2009).
However, part of the acromioclavicular, glenohumeral and scapu-
lothoracic joint orientations differences may come from the static or
dynamic testing conditions but their study could not distinguish the
differences that emerged from the methods or the testing conditions.
Many rehabilitation tests and exercises are executed passively
while the patient is instructed to relax his arm (Ebaugh et al.,
2005). The passive or active condition may modify shoulder joints
orientations and affect the main outcomes of a test or exercise
(Price et al., 2000). Previous shoulder kinematics analyses com-
paring passive and active conditions showed controversial results
(Ebaugh et al., 2005; McQuade and Smidt, 1998; Price et al., 2000;
Qingyun and Gongyi, 1998). The disparity of the methods used in
the previous investigations and their incomplete assessment of the
shoulder joints limits the scope of the ndings.
The clinical interpretation drawn from the investigations of static
vs dynamic and passive vs active conditions is further complicated by
partial measurements of solely the scapulothoracic joint (Fayad et al.,
2006; Johnson et al., 2001; Meskers et al., 2007; Price et al., 2000),
only in the scapular plane (Ebaugh et al., 2005; Johnson et al., 2001;
McQuade and Smidt, 1998; Qingyun and Gongyi, 1998) and a limited
shoulder range of motion (Price et al., 2000). Furthermore, some data
analyses were not designed to contrast static vs dynamic (Hoard II
et al., 2013; Johnson et al., 2001; Lovern et al., 2009; Meskers et al.,
2007) and the interaction between passive vs active and arm eleva-
tion were not included in the statistical methods (Hallstrom and
Karrholm, 2009; McQuade and Smidt, 1998; Price et al., 2000, Qin-
gyun and Gongyi, 1998; Ribeiro and Pascoal, 2015).
The main objective of this study was to evaluate the effect of
conditions of motion on shoulder joints three-dimensional kine-
matics. The specic objectives were to determine the inuence of
static vs dynamic and passive vs active testing conditions on
shoulder joints orientations and measure their interaction with
arm elevation. These testing conditions are expected to exhibit
signicant joint angles differences on all shoulder joints.
2. Methods
2.1. Subjects
Twenty (self-reported) asymptomatic right-handed subjects (10 males and 10
females; age: 2474 years; height: 1.7170.10 m; weight: 68.7711.3 kg) signed a
consent form prior to participation in the study approved by the University Ethics
Committee. The subjects were excluded if they had any history of shoulder disorders,
range of motion limitations or pain. The subjects were not performing strenuous activity
for the shoulder or repetitive overhead movements within their profession or sports.
2.2. Instrumentation
The participants were setup with 35 reective markers on the pelvis (4), thorax
(6), clavicle (5), scapula (9), upper arm (7) and forearm (4) on the dominant upper
limb (Fig. 1). The anatomical markers were placed on anatomical landmarks and
used during a static trial to construct the coordinate systems according to the
International Society of Biomechanics (ISB) recommendations (Wu et al., 2005).
The technical markers were placed on portions of segments less affected by soft
tissue artefact relative to the underlying bone and used during dynamic motion
(Cappozzo et al., 2005). Marker trajectories were tracked by 18 Vicon cameras
(Oxford Metrics Ltd., Oxford, UK) at 100 Hz.
2.3. Experimental procedure
Participants were standing upright in a standardized posture, asked to look
ahead and maintain their trunk stable. The reference position, a relaxed posture

Fig. 1. Schematic representation of degrees of freedom (q) of the thoracopelvic (TP), sternoclavicular (SC), acromioclavicular (AC) and glenohumeral (GH) joints in the chain
model with the technical () and anatomical () marker placement, the functional joint centres () and elbow exion axis (EL) and the X, Y, and Z axes of the coordinate
systems are represented by the dotted grey, plain grey, and dashed black arrows respectively. Reprint with permission from: Robert-Lachaine et al. (in press).

Please cite this article as: Robert-Lachaine, X., et al., 3D shoulder kinematics for static vs dynamic and passive vs active testing
conditions. Journal of Biomechanics (2015), http://dx.doi.org/10.1016/j.jbiomech.2015.07.040i
 X. Robert-Lachaine et al. / Journal of Biomechanics ()
Fig. 2. The static positions consisted of the exion (sagittal) and abduction (frontal) planes of elevation (A) and ve thoraco-humeral elevations (B).
with the arm lying on the side, was used to compute a reference conguration as in
Jackson et al. (2012). They executed three series of ve repetitions of arm exion,
scaption and abduction to warm-up and familiarize themselves with the protocol
(Robert-Lachaine et al., in press; Yoshizaki et al., 2009). To locate joint centres of
rotation, they executed three repetitions of arm exion, scaption and abduction,
shoulder rolls, shrugs and circumductions, along with elbow exion and extension
(Monnet et al., 2007).
2.3.1. Static condition
The static condition consisted of maintaining the arm at four thoracohumeral
elevation angles (30, 60, 90 and 120), each in frontal and sagittal plane of ele-
vation (Fig. 2). Each position was adjusted with a manual goniometer by a kine-
siologist and maintained for 5 s.
2.3.2. Dynamic condition
The dynamic condition was performed in 3 s to raise the arm to approximately
150 and 3 s to descend the arm (
50/s) monitored by a metronome. Thor-
acohumeral elevation and depression was executed in the frontal and sagittal
planes. To control the plane of elevation, visual cues were setup with the manual
goniometer at 90 of arm elevation to indicate the direction of motion.
2.3.3. Active condition
The active condition was executed with the instruction to keep the hand open
and the thumb pointing up for static and dynamic conditions.
2.3.4. Passive condition
For the passive condition, the subject was instructed to completely relax his arm,
which was maintained in position or manipulated by a professional kinesiologist (XRL).
This passive manipulation is known to appropriately relax the subject's shoulder
(McQuade and Smidt, 1998). The starting position was the same in active or passive
conditions. The kinesiologist manipulated the subject's arm from this relaxed position
for the dynamic passive movements.
Three repetitions were executed for each of the four combinations of condi-
tions, namely: static passive, static active, dynamic passive and dynamic active. The
order of the trials was randomly assigned between abduction and exion, static
and dynamic and passive and active conditions.
2.4. Data analysis
The sternoclavicular, acromioclavicular and glenohumeral centre of rotation
and elbow rotation axis were located using functional methods (Ehrig et al., 2006;
O'Brien et al., 2000) to personalize the kinematical chain linking the shoulder
segments (Jackson et al., 2012). The anatomical joint coordinates systems (Fig. 1)
follow the ISB recommendations (Wu et al., 2005). The YXZ Cardan angle
sequence for the sternoclavicular (retraction , elevation and axial rotation ),
acromioclavicular (protraction , lateral rotation , tilt ) and scapulothoracic
(protraction , lateral rotation , tilt ) joints and the YXY Euler angle sequence was observed on scapulothoracic lateral rotation (F3, 57 3.726,
for the glenohumeral (plane of elevation 1, elevation and axial rotation 2) joint
were used as recommended by the ISB (Wu et al., 2005). Reconstruction of joint
kinematics was performed by an extended Kalman lter to attenuate errors due to
occlusions in marker trajectories and soft tissue artefact (De Groote et al., 2008;
Fohanno et al., 2013).
Please cite this article as: Robert-Lachaine, X., et al., 3D shoulder kinematics for static vs dynamic and passive vs active testing
conditions. Journal of Biomechanics (2015), http://dx.doi.org/10.1016/j.jbiomech.2015.07.040i
3
Since the static positions were setup with a manual goniometer, the thor-
acohumeral elevation angles estimated using the kinematic chain did not exactly
correspond to the aimed angles. Mean7SD difference in thoracohumeral elevation
angle between the aimed and measured angle after reconstruction for all positions and
conditions was 1.172.5. Thus cubic interpolations were applied on the static posi-
tions and kinematics were retrieved at 30, 60, 90 and 120 of thoracohumeral
elevation. The mean value of the 12 shoulder angles obtained from the static acqui-
sition was used for each position. For dynamic motion, the 12 mean joint angles of the
raising and lowering phases from the three repetitions were used at the same thor-
acohumeral elevation angles.
2.5. Statistical methods
Normality was veried with Lilliefors tests before using parametric statistics.
Separate four-way repeated measures analyses of variance (ANOVA) were applied on
the 12 dependant variables, the orientations from the sternoclavicular, acromioclavi-
cular, scapulothoracic and glenohumeral shoulder joints (3 angles each). The four
factors were static vs dynamic, passive vs active, thoracohumeral elevation angle (30,
60, 90 and 120) and plane of elevation (sagittal and frontal). The results focused
only on the main effects of static vs dynamic and passive vs active factors and both
their interactions with arm elevation in line with the aim of the study. In the presence
of interaction with thoracohumeral elevation angle, simple main effects were observed
with Bonferonni post hoc testing to adjust for multiple pairwise comparisons. Plane of
elevation was an additional factor to collapse the data from the two planes in the
statistical analyses, but the effects involving this factor were not interpreted since they
were already documented (Ludewig et al., 2009). The marginal mean was calculated
from both planes to indicate a global effect on the shoulder. The marginal mean was
also calculated from the collapsed data of passive and active for the static vs dynamic
contrast or static and dynamic for the passive vs active contrast. Level of statistical
signicance was set a priori at .05 for all analyses. When sphericity was not met
according to Mauchly's test, the HuynhFeldt correction was used. SPSS (SPSS Inc.,
version 21.0, Chicago, IL, USA) was used for statistical analyses.
3. Results
Table 1 presents main effects on the static vs dynamic and
passive vs active conditions and both their interactions with
thoracohumeral elevation angle with respective simple main
effects in Table 2. The complete effects from the four-way ANOVAs
are available in Supplementary 1 (Table S1).
3.1. Static vs dynamic effects
A cross interaction between static vs dynamic and arm elevation
P.016). Scapulothoracic lateral rotation progressed more during
arm elevation in static with a simple main effect at 30 (P.014). At
30 of arm elevation the mean7SD angle was  4.077.2 and
 45.1715.2 at 120 of arm elevation in static, whereas in dynamic
4 X. Robert-Lachaine et al. / Journal of Biomechanics ()
the mean scapulothoracic lateral rotation progressed from
5.778.0 to  42.6716.8 at 30 and 120 of arm elevation
respectively (Fig. 3). A main effect on static vs dynamic was present
on glenohumeral plane of elevation (F1, 19 4.839, P.040) and on
glenohumeral axial rotation (F1, 19 6.910, P.017). The gleno-
humeral joint showed more external rotation in static with a
mean7SD angle of 29.3714.4 compared to  16.7718.6 in
dynamic (Fig. 3). Additional results are also provided to show actual
kinematics for abduction and exion plane of elevation separately
and each for passive and active conditions in Supplementary 1 (Figs.
S1 and S2).
3.2. Passive vs active effects
Interactions between passive vs active and arm elevation were
found for sternoclavicular axial rotation (F3, 57 4.224, P.014),
acromioclavicular protraction (F3, 57 11.936, Po.001), glenohumeral
elevation (F3, 57 6.113, P .003) scapulothoracic protraction
(F3, 57 5.691, P .012), scapulothoracic lateral rotation (F3, 57 7.801,
P.003) and scapulothoracic tilt (F3, 57 6.304, P.011). The ster-
noclavicular joint rotated backwardly less during arm elevation in
passive, where it passed from a mean7SD angle of 6.278.9 to
12.0717.4, while it passed from 4.278.9 to 13.7718.3 in active
(Fig. 4). Mean7SD acromioclavicular protraction angle moved into
retraction in passive passing from 1.274.8 to 5.6712.3 with
simple main effects at 30 (P .009) and 120 (P.001) of arm ele-
vation, but remained relatively stable in active (Fig. 4). Glenohumeral
elevation was similar between passive and active at low arm eleva-
tion, but progressed less in passive at 90 and 120 of arm elevation
with mean7SD angles of  61.279.8 and  77.6712.5 compared
to  63.3710.7 and  81.9715.6 in active (Fig. 4) and post hoc
tests showed a difference at 120 (P.024). Scapulothoracic pro-
traction increased less during arm elevation in passive with
mean7SD angles of 43.078.9 to 44.8718.4 compared to
38.778.9 to 45.6712.5 in active (Fig. 4) and simple main effects
were observed at 30 and 60 (Po.001). A cross interaction was
present on scapulothoracic lateral rotation with simple main effects
at 30 (P.037) and 120 (P .040) where mean7SD progressed
more in passive from  4.177.6 to 46.2715.2 compared to
5.677.6 to 41.4717.4 in active (Fig. 4). In passive the scapu-
lothoracic tilted anteriorly from  12.578.9 to  18.4715.5, while
it tilted posteriorly in active (Fig. 4) with post hoc tests showing
differences at 90 (P.008) and 120 (P.013) of thoracohumeral
elevation.
Main effects on passive vs active were observed on sternoclavi-
cular retraction (F1, 19 25.73, Po.001), sternoclavicular elevation
(F1, 19 4.40, P.050), scapulothoracic protraction (F1, 19 5.11,
P.036) and scapulothoracic tilt (F1, 19 7.67, P.012). Sternoclavi-
cular retraction was less pronounced in passive with a mean7SD
angle of  4.673.9 compared to  6.573.4 in active (Fig. 4).
Sternoclavicular elevation was more pronounced in passive than
active with mean7SD angles of  6.374.4 and  5.574.0
respectively (Fig. 4). Scapulothoracic protraction was higher in pas-
sive with a mean 44.7710.2 compared to 43.179.4 in active
(Fig. 4). Scapulothoracic tilt was less posterior in passive with a
Table 1
P values (signicance identied in bold) of selected interactions and main effects from the 4-way ANOVAs on static vs dynamic (SD), passive vs active (PA), thoracohumeral
elevation angle (TH) and arm plane of elevation for sternoclavicular (SC, SC, SC) acromioclavicular (AC, AC, AC), glenohumeral (GH1, GH, GH2) and scapulothoracic (ST,
ST, ST) joint orientations.
SC SC SC AC AC
SD  TH .776 .913 .165 .564 .056
PA  TH .077 .059 .014 .000 .412
SD .323 .251 .728 .968 .199
PA .000 .050 .222 .078 .433
Please cite this article as: Robert-Lachaine, X., et al., 3D shoulder kinematics for static vs dynamic and passive vs active testing
conditions. Journal of Biomechanics (2015), http://dx.doi.org/10.1016/j.jbiomech.2015.07.040i
mean7SD angle of  14.3710.7 compared to  11.6710.7 in
active (Fig. 4). Additional results are also provided to show actual
kinematics for abduction and exion plane of elevation separately
and each for dynamic and static conditions in Supplementary 1 (Figs.
S3 and S4).
4. Discussion
The conditions of shoulder motion are often neglected in study
design and interpretation of the results. Hence, shoulder joints
kinematics were measured during abduction and exion to con-
trast static positions vs dynamic motion and passive vs active state.
The analysis of complete shoulder kinematics from the sterno-
clavicular, acromioclavicular, glenohumeral and scapulothoracic
joints was never previously analysed with regards to these con-
ditions of motion. As expected, the testing conditions of static vs
dynamic and passive vs active showed signicantly different joint
angles in all shoulder joints indicating an adaptation in shoulder
joints orientations. The main ndings are that scapulothoracic
lateral rotation progressed more during arm elevation in static
than in dynamic by 4.2 and in passive than in active by 6.6, and
that glenohumeral elevation progressed less during arm elevation
in passive than in active by 4.4.
4.1. Static vs dynamic comparison
The contrast between static and dynamic shows the need to
consider these conditions separately for shoulder motion acqui-
sition and interpretation especially for scapulothoracic lateral
rotation. Differences in joint angles between static and dynamic
indicate the amount of error introduced when ignoring these
conditions.
The observation that scapulothoracic lateral rotation progresses
more during arm elevation of about 4.2 in static agrees with the
some descriptive statistics (Hoard II et al., 2013; Johnson et al.,
2001). Similarly, investigations of various arm elevation velocities
show that scapulothoracic motion increases more during arm
elevation at slow motion compared to fast motion (de Groot et al.,
1998; Prinold et al., 2013). Dynamic motion within our study was
executed at a moderate arm angular velocity of approximately
50/s; motion of higher velocities could lead to even more sub-
stantial differences compared to static positions. Superior gleno-
humeral external rotation observed in dynamic is similar to the
results of a recent study (Hoard II et al., 2013). Glenohumeral
external rotation is considered to facilitate arm elevation (Ludewig
et al., 2009). Without sufcient glenohumeral external rotation in
static, compensation with scapulothoracic lateral rotation could
maintain a proper alignment of the humeral head within the
glenoid fossa.
However, the results in our study contradict a study that reported
a more scapulothoracic lateral rotation in dynamic (Fayad et al.,
2006). The disparity may come from the differences in methods.
Kinematics were collected at 30 Hz with an electromagnetic system
where the sensor is directly related to a systematic error associated
AC GH1 GH GH2 ST ST ST
.487 .907 .387 .517 .127 .016 .883
.277 .129 .005 .189 .012 .003 .011
.106 .040 .376 .017 .271 .980 .274
.720 .338 .108 .925 .036 .327 .012
 X. Robert-Lachaine et al. / Journal of Biomechanics () 5

Table 2
P values (signicance identied in bold) of simple main effects from the signicant interactions between static vs dynamic and thoracohumeral elevation angle (SD  TH) and
passive vs active and thoracohumeral elevation angle (PA  TH) with Bonferonni post hoc testing to adjust for the multiple pairwise comparisons.

TH (deg) SC SC SC AC AC AC GH1 GH GH2 ST ST ST

SD  TH 30 .014

60 .369

90 .948

120 .105

PA  TH 30 .127 .009 .917 .000 .037 .346

60 .283 .811 .933 .000 .825 .193

90 .063 .265 .069 .849 .285 .008

120 .089 .001 .024 .659 .040 .013

Fig. 3. Shoulder joint angles during arm elevation in static (grey) and dynamic (black) conditions from both passive and active states and abduction and exion planes of
elevation for sterno-clavicular (SC), acromio-clavicular (AC), gleno-humeral (GH) and scapulo-thoracic (ST) angles (marginal mean and 95% condence intervals) expressed
at 30, 60, 90 and 120 of thoraco-humeral (TH) elevation where signicant main effect (*) and interaction () were identied.

with soft tissue artefacts. The glenohumeral centre of rotation was
estimated with a regression analysis method developed with bony
landmarks on cadavers (Meskers et al., 1998). Finally, the static
positions were setup with a goniometer and accepted within 2 of
the targeted angle. Whereas in our study an optoelectronic system
was set at 100 Hz where soft tissue artefacts associated to each
marker independently was partially compensated by an extended
Kalman lter, centre of rotation were determined functionally (Ehrig
et al., 2006; O'Brien et al., 2000), and interpolation was used to
approximate the exact result of static positions at the aimed angle. A

Please cite this article as: Robert-Lachaine, X., et al., 3D shoulder kinematics for static vs dynamic and passive vs active testing
conditions. Journal of Biomechanics (2015), http://dx.doi.org/10.1016/j.jbiomech.2015.07.040i
6 X. Robert-Lachaine et al. / Journal of Biomechanics ()

Fig. 4. Shoulder joint angles during arm elevation in passive (grey) and active (black) conditions contrasted by the marginal mean from both static and dynamic conditions
and abduction and exion planes of elevation for sterno-clavicular (SC), acromio-clavicular (AC), gleno-humeral (GH) and scapulo-thoracic (ST) angles (marginal mean and
95% condence intervals) expressed at 30, 60, 90 and 120 of thoraco-humeral (TH) elevation where signicant main effect (*) and interaction () were identied.

shift of 10 mm in joint centre estimation can affect shoulder kine-
matics up to 5 (Rab et al., 2002). A predictive approach could lead to
different joint centre of rotation location than a functional approach.
The joint centre approach, the motion analysis system and accepta-
tion of the targeted angle within 2 can all contribute to the disparity
in comparison to Fayad et al. (2006).
An explanation for the solicitation of more scapulothoracic lateral
rotation as arm elevation increases in static could be a strategy to
prevent rotator cuff muscles fatigue. Glenohumeral superior transla-
tion increased during dynamic motion compared to static positions
(Teyhen et al., 2010) and also increased following induced fatigue
(Chopp et al., 2010). Fatigue effect on the shoulder kinematics showed
that scapulothoracic motion was increased during arm elevation in
comparison to pre-fatigue trials (Ebaugh et al., 2006; McQuade et al.,
1998). When maintaining a static position, the scapula was more
laterally rotated than in dynamic motion which should reduce gle-
nohumeral elevation to reach the same arm elevation. Since a main
function of the supraspinatus is glenohumeral elevation (Burke et al.,
2002), a reduced glenohumeral elevation could also reduce the
supraspinatus solicitation. Fatigue appearance could be delayed by
recruiting more resistant muscles such as the trapezius. This idea is
supported by the relative proportion of slow oxidative bre type
which is reduced in glenohumeral muscles compared to scapu-
lothoracic muscles. Biopsies showed a mean proportion of 47% and
50% for the deltoid and supraspinatus compared to 69% and 76% for
the trapezius descendant and transverse respectively (Lindman et al.,
1990; Srinivasan et al., 2007). There seems to be a link between
observed shoulder kinematics following fatigue and the adaptation
used to maintain static positions compared to dynamic motion.
4.2. Passive vs active comparison
The differences between passive and active show the need to
consider these conditions separately for shoulder kinematics
especially for scapulothoracic lateral rotation and glenohumeral
elevation. Up to 6.6 of difference can be expected in healthy
subjects between passive and active conditions.
A few studies corroborate the superior scapulothoracic lateral
rotation and inferior glenohumeral elevation in passive, although
using radiography for motion analysis (Hallstrom and Karrholm,
2009; Qingyun and Gongyi, 1998) or a dynamometer for passive
motion (McQuade and Smidt, 1998). In comparison to Ebaugh et al.
(2005) using an electromagnetic motion capture system, more ster-
noclavicular retraction observed during active motion is in agree-
ment; however, increases in sternoclavicular elevation, scapulothor-
acic protraction and scapulothoracic lateral rotation observed during
passive motion are in opposition. Since passive motion was executed
with a pulley system attached to a splint at the wrist (Ebaugh et al.,
2005), shoulder kinematics could be inuenced and not repre-
sentative of passive clinical assessment. Sternoclavicular elevation
and scapulothoracic lateral rotation could increase due to this
superior pull compared to a passive arm elevation assisted by an

Please cite this article as: Robert-Lachaine, X., et al., 3D shoulder kinematics for static vs dynamic and passive vs active testing
conditions. Journal of Biomechanics (2015), http://dx.doi.org/10.1016/j.jbiomech.2015.07.040i
 X. Robert-Lachaine et al. / Journal of Biomechanics ()
examiner supporting the upper limb. Shoulder joints orientations on
shoulder arthroplasty patients showed that glenohumeral range of
motion was superior in passive than active (Alta et al., 2014). This
differs from our observation that glenohumeral elevation progressed
more during arm elevation in active than passive on healthy subjects.
Since muscular activations are negligible during passive ele-
vation (Ebaugh et al., 2005; McQuade and Smidt, 1998), the pri-
mary role of the rotator cuff muscles to maintain glenohumeral
joint stability is not fullled. The supraspinatus contributes to
glenohumeral elevation, which has shown less progression during
arm elevation in passive. Without muscle activity, many adapta-
tions were observed in passive where the scapula was more lat-
erally rotated, less posteriorly tilted and less protracted. Results
indicate that sternoclavicular elevation and scapulothoracic lateral
rotation may occur more by anatomical mechanics involving
passive elements such as glenohumeral or coracoclavicular liga-
ments, while sternoclavicular backward rotation, sternoclavicular
retraction, scapulothoracic tilt, scapulothoracic protraction and
glenohumeral elevation are more inuenced by muscle actions.
The data provided can justify or help to develop exercises
according to the testing conditions. For example, an exercise seeking
to engage the scapula in motion could be better realised in static to
solicit more scapulothoracic lateral rotation. More studies are needed
to conrm these statements. Studies comparing methods to measure
dynamic motion against palpations at static positions as a reference
(Lovern et al., 2009) must bear in mind that up to 12.6 of the
observed difference may be attributable to testing conditions and not
only to the methods used. Consideration of the condition of motion
should also integrate the development of guidelines for rehabilitation
purposes. Finally, the data from all shoulder joints on healthy subjects
should help clinicians in distinguishing normal differences between
testing conditions from abnormal ones.
The present analysis of shoulder kinematics has revealed that
joints are inuenced by the conditions of motion. Shoulder joints
orientations on healthy subjects were provided according to static or
dynamic and passive or active conditions. Scapulothoracic lateral
rotation showed to progress more during arm elevation in static
compared to dynamic and in passive compared to active, while gle-
nohumeral elevation progressed more during arm elevation in active
than passive. Hence, consideration must be given to the testing
conditions of shoulder motion for acquisition or inter-study com-
parison. Finally, clinicians should take into account the static or
dynamic and passive or active conditions during tests or exercises.
Conict of interest statement
None.
Acknowledgements
The authors acknowledge the Programme MDITIS (NSERC-
CREATE: 371297-2010), the Natural Science and Engineering
Research Council of Canada (NSERC CRD: RDC 396803-10) and the
Laboratoire Orthopdique Mdicus for partial funding of the study.
Appendix A. Supplementary materials
Supplementary data associated with this article can be found in
the online version at: doi:10.1016/j.jbiomech.2015.07.040.
Please cite this article as: Robert-Lachaine, X., et al., 3D shoulder kinematics for static vs dynamic and passive vs active testing
conditions. Journal of Biomechanics (2015), http://dx.doi.org/10.1016/j.jbiomech.2015.07.040i
7
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Please cite this article as: Robert-Lachaine, X., et al., 3D shoulder kinematics for static vs dynamic and passive vs active testing
conditions. Journal of Biomechanics (2015), http://dx.doi.org/10.1016/j.jbiomech.2015.07.040i