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

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.