Biomechanical Analysis of the Closed Kinetic Chain Upper-Extremity Stability Test

in Journal of Sport Rehabilitation
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The closed kinetic chain upper-extremity stability (CKCUES) test is a functional test for the upper extremity performed in the push-up position, where individuals support their body weight on 1 hand placed on the ground and swing the opposite hand until touching the hand on the ground, then switch hands and repeat the process as fast as possible for 15 s.


To study scapular kinematic and kinetic measures during the CKCUES test for 3 different distances between hands.






30 healthy individuals (15 male, 15 female).

Main Outcome Measures:

Participants performed 3 repetitions of the test at 3 distance conditions: original (36 in), interacromial, and 150% interacromial distance between hands. Participants completed a questionnaire on pain intensity and perceived exertion before and after the procedures. Scapular internal/external rotation, upward/downward rotation, and posterior/anterior tilting kinematics and kinetic data on maximum force and time to maximum force were measured bilaterally in all participants. Percentage of body weight on upper extremities was calculated. Data analyses were based on the total numbers of hand touches performed for each distance condition, and scapular kinematics and kinetic values were averaged over the 3 trials. Scapular kinematics, maximum force, and time to maximum force were compared for the 3 distance conditions within each gender. Significance level was set at α = .05.


Scapular internal rotation, posterior tilting, and upward rotation were significantly greater in the dominant side for both genders. Scapular upward rotation was significantly greater in original distance than interacromial distance in swing phase. Time to maximum force in women was significantly greater in the dominant side.


CKCUES test kinematic and kinetic measures were not different among 3 conditions based on distance between hands. However, the test might not be suitable for initial or mild-level rehabilitation due to its challenging requirements.

Tucci is with the Dept of Human Movement Science, Federal University of São Paulo, Santos, Brazil. Felicio is with the Federal University of Uberlândia, Uberlândia, Brazil. McQuade is with the Dept of Rehabilitation Medicine, University of Washington, Seattle, WA. Bevilaqua-Grossi, Camarini, and Oliveira are with the Dept of Biomechanics, Medicine and Rehabilitation of Locomotor Apparatus, University of São Paulo, Ribeirão Preto, Brazil.

Address author correspondence to Helga Tucci at