Measurement properties of handheld dynamometry for assessment of shoulder muscle strength: A systematic review

Pole Dancing-Specific Muscle Strength: Development and Reliability of a Novel Assessment Protocol

BACKGROUND

Pole dancing is a physically demanding sport that combines dance and acrobatic movements on a vertical pole. Despite its highly growing popularity, there is currently limited research in the field. The aim of this study was to create and evaluate a strength assessment protocol for athletes in pole dancing, with a specific focus on functional positions on the pole.

METHODS

Thirty-two female pole dancing athletes participated in this study. Maximal voluntary isometric contractions (MVIC) were measured at three different sport-specific positions on the pole (shoulder abduction and adduction, and hip adduction), on two separate days (test and re-test) with a five to seven day interval between them. A hand-held dynamometer (Activ5- Activbody) stabilized on the pole was used for this study.

RESULTS

The intra-session reliability was good to excellent for all sports-specific positions and for both sides of the body, across all different movements (ICC = 0.837-0.960, SEM = 5.02Kg-2.24Kg, and SDD = 27.46%-14.92%). Slightly better results were found regarding inter-session reliability (ICC = 0.927-0.970, SEM = 3.72Kg-1.97Kg, and SDD = 22.86%-15.19%). There was not a statistically significant difference between the MVICs between the left and right or dominant and non-dominant side in shoulder abduction (p = 0.105) and hip adduction (p = 0.282), in contrast to shoulder adduction (p = 0.00).

CONCLUSION

The strength assessment protocol developed in the current study has proven to be a reliable and functional tool, with the potential for utilization in clinical practice as part of objective strength testing. Further studies are needed in order to expand the protocol to other muscle groups and positions and to generalize the results in all pole dancing populations such as male athletes.

Comparison of shoulder muscle strength, shoulder range of motion and scapular motion in men with ankylosing spondylitis and healthy men: a case-controlled study

Background/Aims

Ankylosing spondylitis mainly affects the vertebral column, meaning that the assessment of the physical function of the upper extremity and scapulothoracic region in ankylosing spondylitis is often overlooked. Therefore, the aim of this study was to investigate shoulder muscle strength, shoulder active range of motion and three-dimensional scapular motion in patients with ankylosing spondylitis.

Methods

The study included 18 men with ankylosing spondylitis, and 16 age-matched typically healthy men as the control group. Muscle strength, active range of motion, and three-dimensional scapular motion were assessed with a digital hand-held dynamometer, an inclinometer, and an electromagnetic tracking device respectively.

Results

A decrease in shoulder flexion and abduction muscle strength on both the dominant side (P<0.001, P=0.001) and non-dominant side (P<0.001, P<0.001) was found in the ankylosing spondylitis group compared to the control group. A decrease in shoulder flexion, abduction, and external and internal rotation active range of motion on both the dominant side (P=0.001, P<0.001, P=0.015, P<0.001, respectively) and non-dominant side (P=0.001, P<0.001, P=0.017, P<0.001 respectively) was observed in the ankylosing spondylitis group. There was an increase in the upward rotation of the scapula on the non-dominant side at 30, 60, and 90° humeral elevations in the ankylosing spondylitis group compared to the control group (P=0.018, P=0.003, P=0.001 respectively). The other parameters of the scapular motion did not differ between groups (P>0.05).

Conclusions

This study showed that shoulder muscle strength and active range of motion were lower, and the upward rotation of the scapula was greater in men with ankylosing spondylitis compared to typically healthy men. The kinetics and kinematics parameters of the shoulder and scapula should be considered when assessing the physical function of patients with ankylosing spondylitis.

Diagnosing, Managing, and Supporting Return to Work of Adults With Rotator Cuff Disorders: A Clinical Practice Guideline

OBJECTIVE: To develop a clinical practice guideline covering the assessment, management, and return to work of adults with rotator cuff disorders. DESIGN: Clinical practice guideline. METHODS: Using systematic reviews, appraisal of the literature, and an iterative approach to obtain consensus from key stakeholders, clinical recommendations and algorithms were developed in the context of the health care system and work environment of the province of Quebec (Canada). RESULTS: Recommendations (n = 73) and clinical decision algorithms (n = 3) were developed to match the objectives. The initial assessment should include the patient's history, a subjective assessment, and a physical examination. Diagnostic imaging is only necessary in select circumstances. Acetaminophen, nonsteroidal anti-inflammatory drugs, and injection therapies may be useful to reduce pain in the short term. Clinicians should prescribe an active and task-oriented rehabilitation program (exercises and education) to reduce pain and disability in adults with rotator cuff disorders. Subacromial decompression is not recommended to treat rotator cuff tendinopathy. Surgery is appropriate for selected patients with a full-thickness rotator cuff tear. A return-to-work plan should be developed early, in collaboration with the worker and other stakeholders, and must combine multiple strategies to promote return to work. CONCLUSION: This clinical practice guideline was developed to assist the multidisciplinary team of clinicians who provide health care for adults with a rotator cuff disorder. The CPG guides clinical decisionmaking for diagnosis and treatment, and planning for successful return to work. J Orthop Sports Phys Ther 2022;52(10):647-664. Epub: 27 July 2022. doi:10.2519/jospt.2022.11306.

Reliability and Validity of the ActivForce Digital Dynamometer in Assessing Shoulder Muscle Force across Different User Experience Levels

Background

Currently available hand-held dynamometers (HHD) offer a more objective and reliable assessment of muscle force production as compared to a manual muscle test (MMT). Yet, their clinical utility is limited due to high cost. The ActivForce (AF) digital dynamometer is a new low-cost HHD with unknown psychometric properties, and its utilization may benefit clinical practice.

Hypothesis/Purpose

This study aimed to determine the AF intra- and inter-tester reliabilities, standard error of measurement (SEM), minimal detectable change (MDC), and criterion validity for assessing shoulder isometric force as compared to the microFET2 (MF2) across testers with different experiences.

Design

Descriptive observational study.

Methods

A convenience sample of 29 healthy adults were assessed twice by each of three testers (two experienced clinicians and a novice PT student) on shoulder external rotation (ER), internal rotation (IR), and forward elevation (FE) using both the AF and MF2 devices. Tester, HHD, and shoulder motion assignment orders were randomized. All testing was performed in a standardized seated position. ER and IR were tested with the shoulder fully adducted. FE was tested at 45° at the scapular plane. All testing and rest periods between testers and tested motions were standardized and monitored via a stopwatch.

Results

Both devices had high intra- [ ER (.95-.98), IR (.97 - .99), FE (.96 - .99)] and inter-tester [ ER (.85-.96), IR (.95 - .97), FE (.88 - .95)] intraclass correlation coefficient (ICC) with comparable intra- (1.68-1.80) and inter-tester (2.36-2.98) SEM, and intra- (4.64-4.97) and inter-tester (6.50-8.24) MDC values across all motions. Tester experience did not affect these values. High (.89-.93) statistically significant Pearson correlations were found between HHDs for all shoulder motions.

Conclusion

Both the AF and MF2 HHDs were found to have high reliability levels across all shoulder motions regardless of tester clinical experience. The AF was also found to be valid for measuring shoulder isometric force production compared to the criterion standard device, the MF2. Its low-cost and electronic accessibility features may promote better compliance for clinicians using dynamometry to objectively assess and store muscle force data in a cost-effective manner.

Level of Evidence

3.