Hartsell H D, Forwell L
Physical Therapy Graduate Program, College of Medicine, University of Iowa, Iowa City 52242-1100, USA.
J Orthop Sports Phys Ther. 1997 Jan;25(1):19-25. doi: 10.2519/jospt.1997.25.1.19.
Considerable variability exists for isokinetic testing of the shoulder rotators, leaving the clinician in a quandry concerning the most appropriate method for patient evaluation. The purpose of this study was to evaluate concentric and eccentric rotational strength in the scapular and neutral planes for the surgical and nonsurgical shoulders. Fifteen males consented to be tested during a 90-minute isokinetic session. Both shoulders for each patient were tested concentrically (240 degrees/sec) and eccentrically (120 degrees/sec) in the scapular and neutral planes. Patient positioning was maintained through the use of a goniometer, plumb line, and floor grid system. Following a warmup, five maximal effort reciprocal internal and external rotation concentric and eccentric contractions were evaluated using multiple two-way analyses of variance (shoulder x plane) with repeated measures. Results indicated no statistically significant differences between the surgical or nonsurgical shoulders for either concentric (p = .063-.247) or eccentric (p = .460-.840) modes, regardless of test plane. No statistically significant differences were observed eccentrically between test planes (p = .06-.470), but the scapular plane produced significantly higher (p = .005) peak torques concentrically. Generally, the external rotators were 53.0% (concentrically) and 63.0% (eccentrically) of the internal rotator strength for either shoulder. Clinically, concentric and eccentric testing of the postoperative shoulder patient can occur in either the scapular or the neutral plane. However, the scapular plane may be preferred since it is more functionally relevant and less injurious to the rotator cuff. A full, functional recovery may be expected for the rotator cuff repair patient.
肩部旋转肌的等速测试存在相当大的变异性，这让临床医生在选择最适合患者评估的方法时陷入两难境地。本研究的目的是评估手术和非手术肩部在肩胛平面和中立平面的向心和离心旋转力量。15名男性同意在90分钟的等速测试过程中接受测试。对每位患者的双肩在肩胛平面和中立平面进行向心（240度/秒）和离心（120度/秒）测试。通过使用角度计、铅垂线和地面网格系统来保持患者的体位。热身之后，使用具有重复测量的多重双向方差分析（肩部×平面）评估五次最大用力的往复内旋和外旋向心及离心收缩。结果表明，无论测试平面如何，手术或非手术肩部在向心（p = 0.063 - 0.247）或离心（p = 0.460 - 0.840）模式下均无统计学显著差异。在离心测试中，各测试平面之间未观察到统计学显著差异（p = 0.06 - 0.470），但肩胛平面产生的向心峰值扭矩显著更高（p = 0.005）。一般来说，任何一侧肩部的外旋肌力量在向心时为内旋肌力量的53.0%，在离心时为63.0%。临床上，术后肩部患者的向心和离心测试可在肩胛平面或中立平面进行。然而，肩胛平面可能更受青睐，因为它在功能上更相关，对肩袖的损伤也更小。对于肩袖修复患者，有望实现完全的功能恢复。
