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Closed Kinetic Chain Upper Extremity Stability test (CKCUES test): a reliability study in persons with and without shoulder impingement syndrome

Helga Tatiana Tucci12*, Jaqueline Martins2, Guilherme de Carvalho Sposito3, Paula Maria Ferreira Camarini4 and Anamaria Siriani de Oliveira2

Author Affiliations

1 Department of Human Movement Science, Federal University of São Paulo, Santos, Brazil

2 Department of Biomechanics, Medicine and Rehabilitation of Locomotor Apparatus, School of Medicine, University of São Paulo, Ribeirão Preto, Brazil

3 Physiotherapy Orthopedic Clinic, Ribeirão Preto, Brazil

4 Post-Graduation Program in Rehabilitation and Functional Performance, University of São Paulo, Ribeirão Preto, Brazil

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BMC Musculoskeletal Disorders 2014, 15:1  doi:10.1186/1471-2474-15-1

Published: 3 January 2014



The Close Kinetic Chain Upper Extremity Stability Test (CKCUES test) is a low cost shoulder functional test that could be considered as a complementary and objective clinical outcome for shoulder performance evaluation. However, its reliability was tested only in recreational athletes’ males and there are no studies comparing scores between sedentary and active samples. The purpose was to examine inter and intrasession reliability of CKCUES Test for samples of sedentary male and female with (SIS), for samples of sedentary healthy male and female, and for male and female samples of healthy upper extremity sport specific recreational athletes. Other purpose was to compare scores within sedentary and within recreational athletes samples of same gender.


A sample of 108 subjects with and without SIS was recruited. Subjects were tested twice, seven days apart. Each subject performed four test repetitions, with 45 seconds of rest between them. The last three repetitions were averaged and used to statistical analysis. Intraclass Correlation Coefficient ICC2,1 was used to assess intrasession reliability of number of touches score and ICC2,3 was used to assess intersession reliability of number of touches, normalized score, and power score. Test scores within groups of same gender also were compared. Measurement error was determined by calculating the Standard Error of the Measurement (SEM) and Minimum detectable change (MDC) for all scores.


The CKCUES Test showed excellent intersession reliability for scores in all samples. Results also showed excellent intrasession reliability of number of touches for all samples. Scores were greater in active compared to sedentary, with exception of power score. All scores were greater in active compared to sedentary and SIS males and females. SEM ranged from 1.45 to 2.76 touches (based on a 95% CI) and MDC ranged from 2.05 to 3.91(based on a 95% CI) in subjects with and without SIS. At least three touches are needed to be considered a real improvement on CKCUES Test scores.


Results suggest CKCUES Test is a reliable tool to evaluate upper extremity functional performance for sedentary, for upper extremity sport specific recreational, and for sedentary males and females with SIS.

Upper extremity; Functional test; Reliability