Intra-Rater and Inter-Rater Reliability of Hand-Held Dynamometry for Shoulder Strength Assessment in Circus Arts Students

Abstract

The purpose of this study was to establish the intra-rater and inter-rater reliability of isometric shoulder strength assessment using a hand-held dynamometer (HHD) in functional joint positions in student circus artists with symptomatic atraumatic shoulder instability. METHODS: Over two testing sessions, two experienced physiotherapists assessed the shoulder strength of 24 student circus artists with clinically diagnosed atraumatic shoulder instability. Both the symptomatic and asymptomatic shoulder was assessed using a HHD in 10 functional positions. Intra-class correlation coefficients (ICCs) were calculated to determine the reliability of strength measurements. RESULTS: All examined positions showed moderate-high intra-rater and inter-rater reliability. External rotation at 0 and internal rotation in horizontal flexion at 45 revealed the most reliable results, and the shrug position the least reliable. Inter-rater and intra-rater reliability was high and demonstrated similar results in symptomatic and asymptomatic shoulders by both raters. DISCUSSION: This study demonstrated clinical applicability in reliably measuring functional strength in symptomatic atraumatic instability or asymptomatic shoulders when assessed by experienced therapists using an HHD.

Effect of a physiotherapy-directed rehabilitation programme on patients with multidirectional instability of the glenohumeral joint: a multimodal interventional MRI study protocol

“…PROMs will be created and emailed to the participant via a secure online link generated by Research Electronic Data Capture (REDCaps) electronic data capture tools (Swinburne University of Technology). 63 Strength positions tested have been previously published 64 and are outlined in online supplemental appendix 4 .…”

“…Assessed with a handheld dynamometer which is a valid and reliable tool to measure shoulder strength with good inter-rater and intrarater reliability (online supplemental appendix 4). 64 114-116 SEM: 1.26-12.52 64 Baseline and 24 weeks MDI…”

Posterior Shoulder Instability in Tennis Players: Aetiology, Classification, Assessment and Management

“…Inter-rater ICC: 0.82-0.96) . 123 A detailed strength testing protocol for shoulder instability using a hand held dynamometer has been previously published 123 and should include a range of shoulder positions, including those in the sagittal plane. 123 Quantifying adequate glenohumeral range of motion for return to sport in PSI can be challenging as it depends on the intervention administered (surgery versus conservative), if the patient's sport is unilateral or bilateral and pre-injury (or normal/ adaptive) side to side TRROM differences.…”

Advances in the Non-Operative Management of Multidirectional Instability of the Glenohumeral Joint

“…Previous MDI studies [ 7 , 8 , 9 ] have shown that group improvements in functional outcomes (including sporting and activity participation) are related to group improvements in muscle strength on a hand-held dynamometer. Shoulder strength testing with hand-held dynamometry has good inter and intra-rater reliability when performed by an experienced practitioner and the protocol used in MDI clinical trials has been published in detail [ 107 ]. Given that a significant proportion of MDI patients may have bilateral problems, normative data in aged-matched sporting populations needs to be established in future research studies.…”