[Isokinetic strength measurement and training of the shoulder: methodology and results].

OBJECTIVE: To evaluate the contribution of isokinetic methods of shoulder strength measurement and training.
METHOD: A Medline search of English and French publications, including referenced articles, allowed us to analyse non-indexed publications. Eighty-seven articles were retained for analysis.
RESULTS: The isokinetic evaluation of the shoulder is valid. Although reproducibility of shoulder evaluation is inferior to that of the knee, it is nevertheless satisfactory when a rigorous test method is used. Normal values for the rotators, abductors-adductors, and extensors-flexors depend on diverse parameters such as age, gender, fat mass, and the type and intensity of physical activity. The agonist to antagonist ratio is particularly informative in pathological conditions. The ratio is modified in cases of impingement syndrome and shoulder instability, and this modification appears to be a cause rather than a consequence of pathologic features. The ratio generally remains modified post-surgery, and normalization must be a major focus of post-surgery rehabilitation.
CONCLUSION: Isokinetic measurement, particularly disturbances in the agonist-antagonist balance, is a reference method for evaluating shoulder muscle strength and detecting deficits in specific muscle groups seen in certain shoulder abnormalities. Such measurement is a valuable tool for orienting rehabilitation towards the deficient muscle groups, complements classical techniques of muscle strengthening, and is an accurate means for following the rehabilitation progress.