Skip to main content
Top
Published in: Clinical Orthopaedics and Related Research® 6/2010

01-06-2010 | Symposium: Current Concepts in Rotator Cuff Disease and Treatment

Isokinetic Muscle Performance Test Can Predict the Status of Rotator Cuff Muscle

Authors: Joo Han Oh, MD, PhD, Jong Pil Yoon, MD, Jae Yoon Kim, MD, Chung Hee Oh, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 6/2010

Login to get access

Abstract

Background

The isokinetic muscle performance test (IMPT) is a validated and objective method used to evaluate muscle function but it is unknown whether it correlates with severity of rotator cuff tears.

Questions/purposes

We asked whether peak torque and total work deficit on the IMPT correlated with the preoperative manual muscle test (MMT), tear size, fatty degeneration (FD) of cuff, and postoperative cuff integrity in patients after rotator cuff surgery.

Methods

We evaluated 221 patients who had undergone rotator cuff repair; of these 86 had the IMPT and a CT arthrogram (CTA) 1 year after surgery.

Results

We found a correlation (r = 0.125~0.464) between the preoperative IMPT and MMT. The IMPT deficit was greater in rotator cuff muscles with larger tears and greater degree of FD. Preoperative external and internal rotation deficits on the IMPT were related to the risk of cuff detachment on the postoperative CTA (r = 0.290, 0.319), and the postoperative abduction deficit was greater than 40% of the contralateral side indicating cuff detachment.

Conclusions

The IMPT provides objective and quantitative data for estimating the preoperative status of rotator cuff tear and can provide baseline data for postoperative anatomic assessment in patients with rotator cuff disorders.

Level of Evidence

Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
Literature
1.
go back to reference Beasley WC. Quantitative muscle testing: principles and applications to research and clinical services. Arch Phys Med Rehabil. 1961;42:398–425.PubMed Beasley WC. Quantitative muscle testing: principles and applications to research and clinical services. Arch Phys Med Rehabil. 1961;42:398–425.PubMed
2.
go back to reference Ellenbecker TS, Davies GJ. The application of isokinetics in testing and rehabilitation of the shoulder complex. J Athl Train. 2000;35:338–350.PubMed Ellenbecker TS, Davies GJ. The application of isokinetics in testing and rehabilitation of the shoulder complex. J Athl Train. 2000;35:338–350.PubMed
3.
go back to reference Elsner RC, Pedegana LR, Lang J. Protocol for strength testing and rehabilitation of the upper extremity. J Orthop Sports Phys Ther. 1983;4:229–235.PubMed Elsner RC, Pedegana LR, Lang J. Protocol for strength testing and rehabilitation of the upper extremity. J Orthop Sports Phys Ther. 1983;4:229–235.PubMed
4.
go back to reference Florence JM, Pandya S, King WM, Robison JD, Baty J, Miller JP, Schierbecker J, Signore LC. Intrarater reliability of manual muscle test (Medical Research Council scale) grades in Duchenne’s muscular dystrophy. Phys Ther. 1992;72:115–122; discussion 122–126.PubMed Florence JM, Pandya S, King WM, Robison JD, Baty J, Miller JP, Schierbecker J, Signore LC. Intrarater reliability of manual muscle test (Medical Research Council scale) grades in Duchenne’s muscular dystrophy. Phys Ther. 1992;72:115–122; discussion 122–126.PubMed
5.
go back to reference Fuchs B, Weishaupt D, Zanetti M, Hodler J, Gerber C. Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elbow Surg. 1999;8:599–605.CrossRefPubMed Fuchs B, Weishaupt D, Zanetti M, Hodler J, Gerber C. Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elbow Surg. 1999;8:599–605.CrossRefPubMed
6.
go back to reference Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC. Fatty muscle degeneration in cuff ruptures: pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res. 1994;304:78–83.PubMed Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC. Fatty muscle degeneration in cuff ruptures: pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res. 1994;304:78–83.PubMed
7.
go back to reference Howell SM, Imobersteg AM, Seger DH, Marone PJ. Clarification of the role of the supraspinatus muscle in shoulder function. J Bone Joint Surg Am. 1986;68:398–404.PubMed Howell SM, Imobersteg AM, Seger DH, Marone PJ. Clarification of the role of the supraspinatus muscle in shoulder function. J Bone Joint Surg Am. 1986;68:398–404.PubMed
8.
go back to reference Itoi E, Minagawa H, Sato T, Sato K, Tabata S. Isokinetic strength after tears of the supraspinatus tendon. J Bone Joint Surg Br. 1997;79:77–82.CrossRefPubMed Itoi E, Minagawa H, Sato T, Sato K, Tabata S. Isokinetic strength after tears of the supraspinatus tendon. J Bone Joint Surg Br. 1997;79:77–82.CrossRefPubMed
9.
go back to reference Kirschenbaum D, Coyle MP Jr, Leddy JP, Katsaros P, Tan F Jr, Cody RP. Shoulder strength with rotator cuff tears: pre- and postoperative analysis. Clin Orthop Relat Res. 1993;288:174–178.PubMed Kirschenbaum D, Coyle MP Jr, Leddy JP, Katsaros P, Tan F Jr, Cody RP. Shoulder strength with rotator cuff tears: pre- and postoperative analysis. Clin Orthop Relat Res. 1993;288:174–178.PubMed
10.
go back to reference Kuhlman JR, Iannotti JP, Kelly MJ, Riegler FX, Gevaert ML, Ergin TM. Isokinetic and isometric measurement of strength of external rotation and abduction of the shoulder. J Bone Joint Surg Am. 1992;74:1320–1333.PubMed Kuhlman JR, Iannotti JP, Kelly MJ, Riegler FX, Gevaert ML, Ergin TM. Isokinetic and isometric measurement of strength of external rotation and abduction of the shoulder. J Bone Joint Surg Am. 1992;74:1320–1333.PubMed
11.
go back to reference Marino M, Nicholas JA, Gleim GW, Rosenthal P, Nicholas SJ. The efficacy of manual assessment of muscle strength using a new device. Am J Sports Med. 1982;10:360–364.CrossRefPubMed Marino M, Nicholas JA, Gleim GW, Rosenthal P, Nicholas SJ. The efficacy of manual assessment of muscle strength using a new device. Am J Sports Med. 1982;10:360–364.CrossRefPubMed
12.
go back to reference Noreau L, Vachon J. Comparison of three methods to assess muscular strength in individuals with spinal cord injury. Spinal Cord. 1998;36:716–723.CrossRefPubMed Noreau L, Vachon J. Comparison of three methods to assess muscular strength in individuals with spinal cord injury. Spinal Cord. 1998;36:716–723.CrossRefPubMed
13.
go back to reference Oh JH, Kim SH, Choi JA, Kim Y, Oh CH. Reliability of the grading system for fatty degeneration of rotator cuff muscles. Clin Orthop Relat Res. 2009 Apr 4. [Epub ahead of print]. Oh JH, Kim SH, Choi JA, Kim Y, Oh CH. Reliability of the grading system for fatty degeneration of rotator cuff muscles. Clin Orthop Relat Res. 2009 Apr 4. [Epub ahead of print].
14.
go back to reference Oh JH, Kim SH, Ji HM, Jo KH, Bin SW, Gong HS. Prognostic factors affecting anatomic outcome of rotator cuff repair and correlation with functional outcome. Arthroscopy. 2009;25:30–39.CrossRefPubMed Oh JH, Kim SH, Ji HM, Jo KH, Bin SW, Gong HS. Prognostic factors affecting anatomic outcome of rotator cuff repair and correlation with functional outcome. Arthroscopy. 2009;25:30–39.CrossRefPubMed
15.
go back to reference Otis JC, Jiang CC, Wickiewicz TL, Peterson MG, Warren RF, Santner TJ. Changes in the moment arms of the rotator cuff and deltoid muscles with abduction and rotation. J Bone Joint Surg Am. 1994;76:667–676.PubMed Otis JC, Jiang CC, Wickiewicz TL, Peterson MG, Warren RF, Santner TJ. Changes in the moment arms of the rotator cuff and deltoid muscles with abduction and rotation. J Bone Joint Surg Am. 1994;76:667–676.PubMed
16.
go back to reference Pearl ML, Perry J, Torburn L, Gordon LH. An electromyographic analysis of the shoulder during cones and planes of arm motion. Clin Orthop Relat Res. 1992;284:116–127.PubMed Pearl ML, Perry J, Torburn L, Gordon LH. An electromyographic analysis of the shoulder during cones and planes of arm motion. Clin Orthop Relat Res. 1992;284:116–127.PubMed
17.
go back to reference Plotnikoff NA, MacIntyre DL. Test–retest reliability of glenohumeral internal and external rotator strength. Clin J Sport Med. 2002;12:367–372.CrossRefPubMed Plotnikoff NA, MacIntyre DL. Test–retest reliability of glenohumeral internal and external rotator strength. Clin J Sport Med. 2002;12:367–372.CrossRefPubMed
18.
go back to reference Rabin SI, Post M. A comparative study of clinical muscle testing and Cybex evaluation after shoulder operations. Clin Orthop Relat Res. 1990;258:147–156.PubMed Rabin SI, Post M. A comparative study of clinical muscle testing and Cybex evaluation after shoulder operations. Clin Orthop Relat Res. 1990;258:147–156.PubMed
19.
go back to reference Rokito AS, Zuckerman JD, Gallagher MA, Cuomo F. Strength after surgical repair of the rotator cuff. J Shoulder Elbow Surg. 1996;5:12–17.CrossRefPubMed Rokito AS, Zuckerman JD, Gallagher MA, Cuomo F. Strength after surgical repair of the rotator cuff. J Shoulder Elbow Surg. 1996;5:12–17.CrossRefPubMed
20.
go back to reference Sapega AA. Muscle performance evaluation in orthopaedic practice. J Bone Joint Surg Am. 1990;72:1562–1574.PubMed Sapega AA. Muscle performance evaluation in orthopaedic practice. J Bone Joint Surg Am. 1990;72:1562–1574.PubMed
21.
go back to reference Teefey SA, Rubin DA, Middleton WD, Hildebolt CF, Leibold RA, Yamaguchi K. Detection and quantification of rotator cuff tears: comparison of ultrasonographic, magnetic resonance imaging, and arthroscopic findings in seventy-one consecutive cases. J Bone Joint Surg Am. 2004;86:708–716.PubMed Teefey SA, Rubin DA, Middleton WD, Hildebolt CF, Leibold RA, Yamaguchi K. Detection and quantification of rotator cuff tears: comparison of ultrasonographic, magnetic resonance imaging, and arthroscopic findings in seventy-one consecutive cases. J Bone Joint Surg Am. 2004;86:708–716.PubMed
22.
go back to reference Thomazeau H, Boukobza E, Morcet N, Chaperon J, Langlais F. Prediction of rotator cuff repair results by magnetic resonance imaging. Clin Orthop Relat Res. 1997;344:275–283.CrossRefPubMed Thomazeau H, Boukobza E, Morcet N, Chaperon J, Langlais F. Prediction of rotator cuff repair results by magnetic resonance imaging. Clin Orthop Relat Res. 1997;344:275–283.CrossRefPubMed
23.
go back to reference Wadsworth CT, Krishnan R, Sear M, Harrold J, Nielsen DH. Intrarater reliability of manual muscle testing and hand-held dynametric muscle testing. Phys Ther. 1987;67:1342–1347.PubMed Wadsworth CT, Krishnan R, Sear M, Harrold J, Nielsen DH. Intrarater reliability of manual muscle testing and hand-held dynametric muscle testing. Phys Ther. 1987;67:1342–1347.PubMed
24.
go back to reference Walker SW, Couch WH, Boester GA, Sprowl DW. Isokinetic strength of the shoulder after repair of a torn rotator cuff. J Bone Joint Surg Am. 1987;69:1041–1044.PubMed Walker SW, Couch WH, Boester GA, Sprowl DW. Isokinetic strength of the shoulder after repair of a torn rotator cuff. J Bone Joint Surg Am. 1987;69:1041–1044.PubMed
25.
go back to reference Yamaguchi K, Tetro AM, Blam O, Evanoff BA, Teefey SA, Middleton WD. Natural history of asymptomatic rotator cuff tears: a longitudinal analysis of asymptomatic tears detected sonographically. J Shoulder Elbow Surg. 2001;10:199–203.CrossRefPubMed Yamaguchi K, Tetro AM, Blam O, Evanoff BA, Teefey SA, Middleton WD. Natural history of asymptomatic rotator cuff tears: a longitudinal analysis of asymptomatic tears detected sonographically. J Shoulder Elbow Surg. 2001;10:199–203.CrossRefPubMed
Metadata
Title
Isokinetic Muscle Performance Test Can Predict the Status of Rotator Cuff Muscle
Authors
Joo Han Oh, MD, PhD
Jong Pil Yoon, MD
Jae Yoon Kim, MD
Chung Hee Oh, MD
Publication date
01-06-2010
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 6/2010
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-009-1169-z

Other articles of this Issue 6/2010

Clinical Orthopaedics and Related Research® 6/2010 Go to the issue

Symposium: Current Concepts in Rotator Cuff Disease and Treatment

Healed Cuff Repairs Impart Normal Shoulder Scores in Those 65 Years of Age and Older