Shoulder Strength Assessment Research Articles

A cross-sectional study to assess the prevalence of frozen shoulder among patients with diabetes mellitus

Purpose: Adhesive capsulitis (AC), is also known as frozen shoulder an insidious painful condition of the shoulder persisting more than 3 months. This inflammatory condition that causes fibrosis of the glenohumeral joint capsule is accompanied by gradually progressive stiffness and significant restriction of range of motion (typically external rotation).this study focusses on identifying frozen shoulder among diabetic patients as glycosylation process causes collagen in the shoulder to get stick which leads to frozen shoulder among type 2 diabetes patients. Methods: This was a cross-sectional study with total of 501 participants with the diagnosis of Diabetic Mellitus (DM).The participants underwent range of motion testing and shoulder strength assessment and Pain assessment using Emoji based Visual Analogue Pain scale. Results: Among 501 patients male were 49.9% and female were 50.9%. the value of HbA1c is categorized as uncontrolled diabetes with HbA1c value as >7 is 6.60% and controlled diabetes with Hba1c value as <7 is 93.4%. Through the preliminary assessment, the mean score for risk assessment is >4 , where 62.7% falls under high risk of frozen shoulder. Conclusion: The study concluded that participants with uncontrolled diabetes have high risk towards developing frozen shoulder. Duration of pain in DM was directly proportional to the high risk of frozen shoulder and females were more affected than males.

Do the Testing Posture and the Grip Modality Influence the Shoulder Maximal Voluntary Isometric Contraction?

Assessing and monitoring shoulder strength is extremely important during rehabilitation. A fixed dynamometer represents a valid and inexpensive assessment method. However, it has not been studied whether posture and grip modality influence shoulder muscle strength. The aim of this study was to compare shoulder strength values between sitting and standing positions and between the handle and cuff grip modalities. A total of 40 volunteers were divided into a posture (PG) and a handle-cuff group (HCG). Participants in the PG were asked to perform a maximum voluntary isometric contraction (MVIC) for shoulder flexion, extension, ab-adduction, and intra-extra rotation in standing and sitting positions. The HCG participants were tested in a standing position while holding a handle or with a cuff around their wrist. PG showed higher forces in the standing position for shoulder flexion (p = 0.009); internal rotation showed higher values in the sitting position (p = 0.003). ER/IR ratio was significantly higher in the standing position (p < 0.001). HCG showed higher significant forces during cuff modality in all positions and grip modalities, including the ER/IR ratio (p < 0.05). Different body positions and grip modalities influenced the assessment of shoulder strength as recorded by a fixed dynamometer; therefore, these factors should be carefully considered when carrying out a shoulder strength assessment, and we encourage the development of assessment guidelines to make future clinical trial results comparable.

Reliability of two devices for shoulder strength assessment: Wii Fit Balance Board and hand-held dynamometer.

The aim of this study was to compare the reliability and agreement between two devices - Wii Fit Balance Board (WBB) versus Hand-Held Dynamometer (HHD) to measure isometric strength during the athletic shoulder (ASH) test in healthy amateur rugby players. Fifteen males (23.73 ± 2.8 years) completed two testing sessions. Maximal isometric contractions using the dominant arm (D) and non-dominant arm (ND) against a WBB and HHD were assessed at three angles of abduction (180°, 'I'; 135°, 'Y' and 90°, 'T'), in a prone lying position. The results indicate a very large correlation between the HHD and the WBB. WBB provides acceptable reliability at I-Test D (CV = 9.97%, ICC = 0.88) and HHD in the I-Test D (CV = 8.90%, ICC = 0.94), I-Test ND (CV = 8.60%, ICC = 0.95) in peak strength values. The HHD is most reliable in D ASH I-Y-T (CV = 10.94%) and WBB (CV = 11.05%). In the ND ASH I-Y-T test, the HHD is the most reliable (CV = 12.5%) compared to the WBB (CV = 14.43%). These results suggest that WBB is a reliable device to assess strength in the ASH test with a very large correlation with the HHD. WBB and HHD are two affordable devices to assess isometric shoulder strength.

Validity and reliability of the DiCI for the measurement of shoulder flexion and abduction strength in asymptomatic and symptomatic subjects.

BackgroundA higher risk of shoulder injury in the athletic and non-athletic population is frequently associated with strength deficits. Therefore, shoulder strength assessment can be clinically useful to identify and to quantify the magnitude of strength deficit. Thus, the aim of this study was to evaluate the validity and reliability of a DiCI (a new hand-held dynamometer) for the measurement of shoulder flexion and abduction strength in asymptomatic and symptomatic subjects.MethodsForty-three recreational athletes (29 males and 14 females; age: 22.1 ± 0.47 years; body mass: 68.7 ± 13.1 kg; height = 173.3 ± 9.7 cm) and 40 symptomatic subjects (28 males and 12 females; age: 49.9 ± 8.1 years; body mass: 70.6 ± 14.3 kg; height = 171.7 ± 9.0 cm) completed shoulder flexion and abduction strength tests in two identical sessions one-week apart. Both types of movement were evaluated at 45º and 90º.ResultsRelative reliability analysis showed excellent intra-class correlation coefficients (ICC) for all evaluated movements (ICC range = 0.90 to 0.99). Absolute reliability analysis showed a standard error of measurement (SEM) ranging from 1.36% to 2.25%, and minimal detectable change (MDC) ranging from 3.93% to 6.25%. In conclusion, the DiCI is a valid and reliable device for assessing shoulder strength both in recreational athletes and in subjects with restricted mobility and loss of strength.

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

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. 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. 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.

The validity of the sphygmomanometer for shoulder strength assessment in amateur rugby union players

ObjectivesTo determine the concurrent validity of a sphygmomanometer for assessing shoulder strength in the I, Y and T positions during the athletic shoulder test (ASH test). Force platforms were used as the gold standard measurement tool for this purpose. DesignShoulder strength was assessed using force platforms and a sphygmomanometer, both placed on the floor and the participant positioned prone. One rater assessed strength, taking three measurements in each of the I, Y and T positions, using the sphygmomanometer and force platforms. Concurrent validity was calculated using the force platforms as the gold standard device. SettingData was collected within the treatment room of an amateur rugby club. ParticipantsTwenty male amateur rugby players (25.15 years old ± 3.27 years) were recruited for this study. Main outcome measuresPeak force across the shoulder girdle was assessed using the force platforms and sphygmomanometer which provided values in Newtons (N) and millimetres of mercury (mmHg) respectively. ResultsResults showed high concurrent validity (Pearsons r = 0.76–0.81) between the sphygmomanometer and the force platform. Coefficient of determination (r2 = 0.59–0.67) showed the sphygmomanometer to have a valid predictive model in the I, Y and T positions. ConclusionsThe sphygmomanometer is suitable for monitoring force transfer across the shoulder during the ASH test, and is able to quantify peak force in mmHg. The sphygmomanometer enables coaches and clinicians to accurately quantify force production across the shoulder girdle in order to screen and monitor players at a low cost.

A Triple Application of Kinesio Taping Supports Rehabilitation Program for Rotator Cuff Tendinopathy: a Randomized Controlled Trial

Rotator cuff tendinopathy (RoCT) is a common pathology among adults. Kinesio-taping (KT) represents a possible rehabilitative treatment. The aim of the present study is to investigate the efficacy of a combination of three different applications of KT combined with a standardized protocol of rehabilitative exercises in reducing pain and in functional recovery in patients affected by RoCT. 21 patients were enrolled in a real group (RG) and 19 in a sham group (SG). RG received a real KT application and SG received a sham KT application. Both groups received the same rehabilitative protocol. A Numeric Rating Scale (NRS) for shoulder pain, Medical Research Council (MRC) Scales for shoulder strength assessment and Costant Murley Score (CMS) were administered before (T0) and at the end of treatment (T1). Within-group analysis for RG at T1 showed significant improvement in: NRS at-rest (p=0.002), during-movement (p&lt;0.001); CMS (p&lt;0.001); MRC shoulder flexion (p=0.003), extension (p=0.005), abduction (p=0.003), adduction (p=0.007), external rotation (p=0.011), internal rotation (p=0.002), elbow flexion (p=0.008) and extension strength (p=0.011). Within-group analysis for SG at T1 showed significant improvement in: during-movement NRS (p=0.010); CMS (p&lt;0.001). 1. KT application combined with conventional rehabilitative treatment can facilitate immediate pain reduction during rehabilitative treatment. 2. KT application combined with conventional rehabilitative treatment can increase function recovery. 3. KT application combined with conventional rehabilitative treatment can increase strength recovery. 4. Our findings however are not strong enough to recommend the application of KT during rehabilitative treatment for RoCT. 5. These results are the basis for future prospective, randomized controlled trials of larger samples of patients.

Comparison of shoulder strength assessment in scaption with an isometric dynamometer and a weighing machine: a pilot study

BackgroundStrength testing is an important aspect of shoulder examination. To date, strength assessment has many limitations. There is no single standard instrument for measuring, and various current devices have problems in reliability, accuracy, and cost. This study compared the results of an innovative and simple method of strength testing (weighing machine) with an existing method (isometric dynamometer).MethodsShoulder strength was tested in 80 individuals, 60 with normal shoulders (group 1) and 20 with shoulder pathology (group 2). Strength was tested in the standard position of 90° of elevation in the scapular plane (scaption) with the elbow extended and forearm pronated while resistance was applied just proximal to the wrist. A weighing machine and an isometric dynamometer were used for strength testing.ResultsThere was a mean difference of 0.26 kg in group 1 (95% confidence interval [CI], 0.16-0.36; P < .0001) and 0.30 kg in group 2 (95% CI, 0,04-0,72; P = .0291) between the weighing machine and the isometric dynamometer. Although statistically significant, these differences were not clinically significant.ConclusionsThis pilot study shows that strength assessment by an innovative and simpler technique with a weighing machine gives similar results as an isometric dynamometer.

Validity and reliability of shoulder strength assessment during scaption, internal rotation and external rotation using an anchored, non-modified sphygmomanometer

PurposeTo determine the validity, intra-rater reliability, and inter-rater reliability of an anchored sphygmomanometer for assessing shoulder strength during scaption, lateral rotation, and medial rotation. The hand-held dynamometer (HHD) was used as the standard measurement tool for this purpose.MethodsFifty subjects (23 years old ±3 years) were included in the validity study. Shoulder strength was assessed using an HHD and a sphygmomanometer, both anchored to a fixed ladder by an inextensible belt. Twenty-three subjects (25 years old ±3 years) were included in the reliability study. Two raters assessed strength, each taking two measurements one week apart, using the fixed sphygmomanometer.ResultsValidity results showed high to very high magnitude correlations, and no differences were found between the sphygmomanometer and the HHD measurements or among trials. Intra-class coefficient of correlation (ICC) showed high reliability between measurement tools and among trials. Intra-rater results showed very high ICC, very high correlation, low coefficient of variation (CV) with adequate standard error of measurement (SEM), and minimal detectable change (MDC). Inter-rater results showed moderate to high ICC, high to very high correlation, acceptable SEM and CV, but not adequate MDC. The anchored sphygmomanometer is a low-cost tool that provides objective measurements. The results obtained from the anchored sphygmomanometer were found to be similar to those obtained from an HHD, which has a valid predictive model.ConclusionsThe sphygmomanometer is suitable for monitoring shoulder strength during scaption, internal rotation, and external rotation. The anchored sphygmomanometer enables coaches and physical therapists to establish the maximal voluntary isometric contraction and monitor exercise program outcomes at a low cost. However, caution is recommended when interpreting results between raters.

The use of a sphygmomanometer to measure shoulder isometric strength: a validity and reliability study

Abstract Introduction: A sphygmomanometer is an instrument commonly used to measure blood pressure that can potentially be used to objectively assess shoulder isometric muscle strength. Objective: To establish the criterion validity and the intra-rater reliability of the sphygmomanometer for the assessment of shoulder isometric muscular strength compared to the handheld dynamometer. To determine if there is a statistically significant difference for shoulder strength between dominant and non-dominant sides. Methods: A test-retest study design was developed, where a rater assessed shoulder flexion and abduction isometric strength of 13 healthy university students, using a commercially available sphygmomanometer and a handheld dynamometer. Results: The criterion validity of the sphygmomanometer was found to be good for both right and left shoulder flexion and abduction strength assessment (Pearson’s r = 0.90-0.97). The intra-rater reliability of the sphygmomanometer was calculated to be good for both right and left flexion and abduction (ICC = 0.96-0.99). The handheld dynamometer also showed good intra-rater reliability for each of the strength measures assessed (ICC = 0.94-0.98). Significant differences (p &lt; 0.01) were identified between dominant and non-dominant sides for shoulder strength. Conclusion: A sphygmomanometer is a simple and easily accessible tool that provides clinicians with accurate objective values for isometric shoulder strength assessment.

A comparison of methods for shoulder strength assessment and analysis of Constant score change in patients aged over fifty years in the United Kingdom

Normal values for shoulder assessment are imperative for the diagnosis of pathology and measurement of treatment outcome. Normal values for the United Kingdom are currently not known. This study comprised 108 control patients aged over 50 years who were under the care of one general practitioner, and the Constant score was measured. The Constant score was assessed via 3 techniques for strength measurement: maximum strength with myometer, mean strength with myometer, and maximum strength with fixed spring balance. Myometer maximum strength values were very similar to fixed spring balance maximum strength values, with a mean difference of 0.5. Myometer mean strength was lower than myometer maximum strength by 3 points. Age and sex both significantly affected Constant score (P < .001 for both). The Constant score fell by 0.3 points per year over 50 years of age. Men had a score that was 7.5 points greater than that in women. The Constant score decreases predictably with age in the United Kingdom. Methods of strength assessment are not the same. A uniform method of shoulder strength assessment is required to allow for meaningful comparisons between series.

Predicting shoulder strength using allometry: implications for shoulder outcome assessments

Introduction: Shoulder strength is an integral component of shoulder function. In assessing shoulder function many functional scales rely on direct or indirect measures of strength. Strength, and thus these scales, is often highly correlated with age. We propose an allometric method for assessing shoulder strength. Allometric modeling has provided accurate predictions of biologic growth and physiologic function in both human and animal studies. Allometry utilizes the relationship between the two homologous structures on the left and right sides of the body, providing in effect an internal control and thus eliminating many confounding effects, e.g. age and level of activity. Methods: Twenty patients with unilateral shoulder dysfunction underwent strength testing of their affected and unaffected shoulder. Strength testing of the bilateral shoulders was also assessed in twenty people without shoulder pain in order to delineate the effect of hand dominance on strength in those without shoulder pain. Absolute and predicted strength deficits of the involved shoulder were calculated via regression analysis. Pearson's correlation coefficients were computed between age and strength. Results: Utilizing the contralateral extremity as an internal control eliminates age as a confounding variable in predicting strength outcomes ( r=0.093). Conclusion: Allometric concepts, applied to shoulder strength assessment, eliminates age as a confounding variable. Strength testing of both shoulders should be considered in the development of future shoulder outcome scales in order to eliminate the strong influence of age.