Kinetic chain revisited: consensus expert opinion on terminology, clinical reasoning, examination, and treatment in people with shoulder pain

Objectives: To determine the most appropriate terminology and issues related to clinical reasoning, examination and treatment of the kinetic chain (KC) in people with shoulder pain by an international experts panel. Design: Delphi studyMethods: A three-round Delphi study that involved an international panel of experts with Conclusion:This study defined a list of 102 items across five different domains (terminology, rationale and clinical reasoning, subjective examination, physical examination and treatment) regarding to KC in people with shoulder pain.The term KC was preferred and a definition for this concept agreed.Dysfunction of a segment in the chain (i.e., weak link) was agreed to result in altered performance or injury to distal segments.Experts considered important to assess and treat the KC in particular in throwing/overhead athletes and agreed that no one size fits all approach exist when implementing shoulder KC exercises within the rehabilitation process.Further research is now required to determine the validity of the identified items.