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Assessment of shoulder rotation strength, muscle co-activation and shoulder pain in tetraplegic wheelchair athletes – A methodological study

The Journal of Spinal Cord Medicine, 2022 · DOI: 10.1080/10790268.2020.1803659 · Published: July 1, 2022

Spinal Cord InjuryOrthopedics

Simple Explanation

This study aimed to create a good way to measure shoulder strength in wheelchair athletes with tetraplegia. It also looked at how well a simpler strength test (HHD) compares to a more complex one (ID). The study also examined how shoulder muscles activate during strength tests and if there's a connection between shoulder strength and pain in these athletes. The research found a reliable method for measuring shoulder strength. The simpler strength test was comparable to the more complex one, but with some differences in muscle activity. Strength wasn't clearly linked to shoulder pain.

Study Duration
January 2017 to February 2017
Participants
Twelve adult tetraplegics
Evidence Level
Descriptive methodological

Key Findings

  • 1
    A standardized feasible protocol for tetraplegic wheelchair athletes for measuring maximum shoulder rotation strength was established.
  • 2
    Isometric HHD is comparable with ID on normalized peak torques and muscle activity, but with larger co-activation.
  • 3
    Strength was not clearly associated with shoulder pain, except for significantly weak negative associations between ID and pain during ER for left and right arms.

Research Summary

This study established a standardized, feasible protocol for measuring shoulder rotation strength in tetraplegic wheelchair athletes. It found that isometric handheld dynamometry (HHD) is comparable to isokinetic dynamometry (ID) for measuring normalized peak torques. Muscle activity during maximum shoulder rotation was similar between HHD and ID, although HHD showed greater muscle co-activation during external rotation. The study found no clear association between shoulder strength and shoulder pain. The authors suggest that isometric HHD is a feasible and valid method for measuring shoulder rotation strength in tetraplegics and can be used in clinical and sports settings.

Practical Implications

Clinical Practice

Isometric HHD can be used as a feasible and valid tool for assessing shoulder rotation strength in tetraplegic wheelchair athletes in clinical settings.

Sports Rehabilitation

The established protocol can be implemented in sports rehabilitation programs for tetraplegic athletes to monitor and improve shoulder strength.

Future Research

Further research is recommended on test-retest reliability of the current test procedures for isometric HHD to enhance the confidence in its application.

Study Limitations

  • 1
    The convenience sampling method and the small sample size, limiting generalizability.
  • 2
    The wide range of injury level, which may introduce heterogeneity.
  • 3
    Power calculations were not performed due to the exploratory nature of the study and the limited studies on this area.

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