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The Journal of Bone and Joint Surgery, Vol 74, Issue 9 1320-1333, Copyright © 1992 by Journal of Bone and Joint Surgery, Inc
Isokinetic and isometric measurement of strength of external rotation and abduction of the shoulder
JR Kuhlman, JP Iannotti, MJ Kelly, FX Riegler, ML Gevaert and TM Ergin
Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Philadelphia.
The strength of active external rotation and of abduction of the shoulder
when the humerus was in the plane of the scapula (30 degrees of horizontal
flexion anterior to the coronal plane) was measured isokinetically and
isometrically in thirty-nine normal volunteers, who were stratified by age
and sex. The angles at which peak torque was produced were similar when
tested isokinetically and isometrically; these angles were similar for
external rotation (at 60 and 30 degrees of internal rotation) and for
abduction (at 30 and 60 degrees of abduction). Isometric peak torque was
greater than slow-speed (90 degrees per second) isokinetic peak torque,
which in turn was greater than fast-speed (210 degrees per second)
isokinetic peak torque. There were highly significant differences in
strength, measured isokinetically and isometrically, between younger and
older men and between older men and older women. The variability of normal
values for torque was similar in each group. Repeat testing demonstrated a
high reliability of isokinetic measurements and of isometric measurements
at angles within the range of the production of peak torque. Complete
testing was performed in four normal volunteers before and after a block of
the suprascapular nerve. The supraspinatus and infraspinatus components of
the rotator cuff contributed a variable proportion to the total strength of
abduction (25 to 50 per cent) and external rotation (50 to 75 per cent)
throughout the range of motion. This study demonstrated that both
isokinetic and isometric testing in the scapular plane are valid methods
for measurement of the strength of external rotation and abduction of the
shoulder. The data support standardization of the positions for testing the
strength of motions of the shoulder: isometric strength of external
rotation should be measured in the scapular plane with the shoulder in 45
degrees of abduction and 45 degrees of internal rotation; isometric
strength of abduction, in the scapular plane with the shoulder in 45
degrees of abduction; and isokinetic strength of external rotation and
abduction, in the scapular plane at 90 degrees per second.
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