Isokinetic evaluation of rotational strength in normal shoulders and shoulders with impingement syndrome

Leroux, Jean‐Paul; Codine, P.; Thomas, E; Pocholle, M.; Mailhe, D; Blotman, F

doi:10.1016/s1058-2746(95)80091-3

Cited by 44 publications

(74 citation statements)

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“…Isokinetic testing in a SSI group and an asymptomatic group using a similar age group, tested in the seated position, with the shoulder positioned in the scapular plane, has been reported in five previous studies (Dulgeroglu et al, 2013;Erol et al, 2008;Leroux et al, 1994;MacDermid et al, 2004;Tyler et al, 2005).…”

Section: Discussionmentioning

confidence: 79%

“…Other studies which used the same isokinetic testing position to compare an SSI group with an asymptomatic group did not report dominance of the recruited participants but then analysed within group differences for the (1) painful and nonpainful shoulders in those with SSI and (2) dominant versus non-dominant shoulder in an asymptomatic group and then (3) compared the values from these two analyses (Leroux et al, 1994;MacDermid et al, 2004;Tyler et al, 2005). This statistical analysis differs from the analysis in this study.…”

Section: Discussionmentioning

confidence: 96%

“…The testing method has been shown to be reliable when testing a group experiencing SSI and an asymptomatic group (MacDermid et al, 2004) and has been used in similar studies (Dulgeroglu, Kirbiyik, Ersoz, & Ozel, 2013;Erol, Ozcakar, & Celiker, 2008;Leroux et al, 1994;Tyler et al, 2005).…”

Section: Methodsmentioning

confidence: 99%

“…This sample size was adequate when compared with a calculation based on an isokinetic study comparing rotator cuff strength in a diagnosed SSI group with an asymptomatic group, peak torque external rotation at 60 degrees per second (mean difference 10Nm, standard deviation 2Nm (Leroux et al, 1994)) .…”

Section: Power Analysismentioning

confidence: 99%

“…Reinold et al, 2007;Tate, McClure, Young, Salvatori, & Michener, 2010). Previous isokinetic studies comparing rotator cuff strength in a diagnosed SSI group with an asymptomatic group analysed within group differences of the (1) painful versus non-painful shoulder in those with SSI and (2) dominant versus non-dominant shoulder in an asymptomatic group and then (3) compared the values from these two analyses (Leroux et al, 1994;MacDermid, Ramos, Drosdowech, Faber, & Patterson, 2004;Tyler, Nahow, Nicholas, & McHugh, 2005). Although comparison of dominant and non-dominant limbs have been reported there is no indication that matched dominance was considered in recruitment of symptomatic and asymptomatic group participants in these studies.…”

Section: Introductionmentioning

confidence: 99%

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Isokinetic clinical assessment of rotator cuff strength in subacromial shoulder impingement

Land

Gordon

Watt

2017

Musculoskeletal Science and Practice

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Background: Current conservative management of subacromial shoulder impingement (SSI) includes generic strengthening exercises, especially for internal (IR) and external (ER) shoulder rotators. However, there is no evidence that the strength or the ratio of strength between these muscle groups is different between those with SSI (cases) and an asymptomatic population (controls).Objective: To identify if isokinetic rotator cuff strength or the ratio of strength is significantly different between cases and controls.Study Design: Case Control Study.Method: Fifty one cases with SSI and 51 asymptomatic controls matched for age, gender, hand dominance and physical activity level completed isokinetic peak torque glenohumeral IR and ER testing. Within the SSI group, 31 dominant limbs were symptomatic and 20 non-dominant limbs were symptomatic. IR and ER were measured separately using continuous reciprocal concentric (con) and eccentric (ecc) contraction cycles at a speed of 60 0 degrees per second and again at 120 0 degrees per second. Values of peak torque (PT), relative peak torque (RPT) and ratios were compared using independent t-tests between the SSI and asymptomatic groups.Results: Significant strength differences between the two groups were present only when the symptomatic SSI shoulder was the dominant shoulder (con ER PT at 60 0 /second, ecc ER PT at 120 0 /second, ecc ER RPT at 120 0 /second and ecc IR PT at 60 0 /second and 120 0 /second). Conclusions:Changes in rotator cuff strength in SSI may be related to limb dominance, which may have implications for strengthening regimes. Level of Evidence:Level 3a

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 96%

Section: Methodsmentioning

confidence: 99%

Section: Power Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Isokinetic clinical assessment of rotator cuff strength in subacromial shoulder impingement

Land

Gordon

Watt

2017

Musculoskeletal Science and Practice

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Kinetic strategies of patients with shoulder impingement syndrome

Doiron

Delacroix

Denninger

et al. 2009

Journal Orthopaedic Research

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Our aim was to determine whether subjects with shoulder impingement syndrome (SIS) have abnormal multijoint torque patterns compared to healthy subjects during normalized isometric force along specific directions. Subjects had to generate an isometric force corresponding to 40% of the maximal pain-free force. Eight targets were displayed on a monitor (0, 45, 90, 135, 180, 225, 270, and 3158). We calculated shoulder and elbow torques (kinetic strategies) using a biomechanical model. Regardless of the target location, the SIS group succeeded in reaching the target; however, when compared to the healthy subjects, they needed more time to do so, suggesting that SIS may slow down the execution of the kinetic strategies. Moreover, the SIS group produced lower shoulder external/internal torque to reach the targets located at 08 and 2258, and they generated greater abduction/adduction torque for targets located at 0, 135, and 1808. In addition, they had lower elbow extension/flexion torque for the target located at 3158. The investigation of atypical kinetic strategies is essential to provide an understanding of the pathomechanics of the SIS and to develop more effective treatment strategies. Shoulder impingement syndrome (SIS) is an encroachment of the subacromial bursa and the rotator cuff that results from the narrowing of the subacromial space. 1 There are two predominant theories about the cause of impingement. The intrinsic theory suggests that tendon degeneration, due to overuse, tension overload, or trauma lead to muscle weakness and lack of shoulder movements coordination. In contrast, the extrinsic theory proposes that impingement is caused by factors unrelated to the tendon. Despite the controversy regarding the etiology, SIS is a general term related to pathology involving the rotator cuff, biceps tendon, and subacromial bursa. 2 SIS constitutes a medical, social, and economic impairment on society, 3 with diagnosed cases of rotator cuff pathology usually resulting in impaired physical health and lower quality of life. 4 Kinematic changes at the scapula are associated with SIS. 2,5 Moreover, altered dynamic stability of the shoulder is associated with SIS, 6 a decreased rotator cuff contribution during arm elevation associated with an increased contribution of the deltoid, and an altered force production of the deltoid and the supraspinatus or a dysfunctional rotator cuff can result in increased superior translation of the humeral head. 1,5,7 Nonetheless, electromyography results from a limited set of muscles inevitably provide an incomplete picture of coordination disturbances following SIS.During the last decade, the impact of rotator cuff pathology on either isokinetic or isometric strength has been quantified. 4,[8][9][10] Overall, results revealed that patients have lower strength than healthy subjects. But these studies did not measure shoulder internal/ external, adduction/abduction, and flexion/extension and elbow joint torque coupling. Accordingly, the objective of this study was to determ...

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Open versus arthroscopic subacromial decompression: analysis of one‐year results

T'Jonck

Lysens

Smet³

et al. 1997

Physiotherapy Res Intl

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The results of open subacromial decompression (OSD) were compared with arthroscopic subacromial decompression (ASD) after 1 year in 32 subjects (4 bilateral), and the correlation between the two shoulder rating scales for impingement was documented. Patients were evaluated clinically on the modified University of California at Los Angeles (UCLA) shoulder rating scale, and Constant scale. Scapular position and rotation were evaluated as well as a rotation and abduction shoulder strength test using the Cybex II dynamometer. No parameters revealed significant differences between the groups, except for the UCLA score which indicated an advantage for the ASD group (p = 0.046). The OSD group scored 24.5 (5.45) on the UCLA scale and 73.8 (18.9) on the Constant scale, whereas the ASD group scored 28.3 (5.6) and 80.8 (16.4). To study the correlation between both scales, the Pearson correlation product-moment coefficient was calculated and a high correlation (r = 0.81) obtained. Less mobility was found in the operated arm for all parameters, with the exception of glenohumeral abduction in both groups and passive elevation in the OSD group. Only in the OSD group did the scapula in the operated extremity show more abduction of the inferior angle of the scapula. Weaker abduction strength in the operated side was found in the ASD group, whereas in the OSD group there was significantly less adduction and external rotation strength at 180 degrees/s en 240 degrees/s. We conclude that after one year the open group tends to catch up with the arthroscopic patients and that the main benefits after arthroscopic surgery as described in literature are more evident in the shorter period.

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Isokinetic evaluation of rotational strength in normal shoulders and shoulders with impingement syndrome

Cited by 44 publications

References 0 publications

Isokinetic clinical assessment of rotator cuff strength in subacromial shoulder impingement

Isokinetic clinical assessment of rotator cuff strength in subacromial shoulder impingement

Kinetic strategies of patients with shoulder impingement syndrome

Open versus arthroscopic subacromial decompression: analysis of one‐year results

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