Kuhlman J R, Iannotti J P, Kelly M J, Riegler F X, Gevaert M L, Ergin T M
Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Philadelphia.
J Bone Joint Surg Am. 1992 Oct;74(9):1320-33.
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.
对39名按年龄和性别分层的正常志愿者，在肱骨处于肩胛平面（冠状面前方30度水平屈曲）时，等速和等长测量了肩关节主动外旋和外展的力量。等速和等长测试时产生峰值扭矩的角度相似；外旋（内旋60度和30度时）和外展（外展30度和60度时）的这些角度相似。等长峰值扭矩大于低速（每秒90度）等速峰值扭矩，而低速等速峰值扭矩又大于高速（每秒210度）等速峰值扭矩。年轻男性与年长男性之间以及年长男性与年长女性之间，等速和等长测量的力量存在高度显著差异。每组扭矩正常值的变异性相似。重复测试表明，在峰值扭矩产生范围内的角度进行等速测量和等长测量具有很高的可靠性。在4名正常志愿者进行肩胛上神经阻滞前后进行了完整测试。在整个运动范围内，肩袖的冈上肌和冈下肌成分对外展（25%至50%）和外旋（50%至75%）的总力量贡献比例各不相同。本研究表明，在肩胛平面进行等速和等长测试都是测量肩关节外旋和外展力量的有效方法。数据支持对测试肩部运动力量的位置进行标准化：外旋等长力量应在肩胛平面，肩关节外展45度和内旋45度时测量；外展等长力量应在肩胛平面，肩关节外展45度时测量；外旋和外展等速力量应在肩胛平面，每秒90度时测量。
