Literature DB >> 19181972

Shoulder strength in asymptomatic individuals with intact compared with torn rotator cuffs.

H Mike Kim1, Sharlene A Teefey, Ari Zelig, Leesa M Galatz, Jay D Keener, Ken Yamaguchi.   

Abstract

BACKGROUND: Normative data are essential to the evaluation of shoulder function. The purposes of this study were to establish a normative database of isometric shoulder strength measured in asymptomatic individuals verified to have intact rotator cuffs and to determine the effect of asymptomatic rotator cuff tears on shoulder strength.
METHODS: Two hundred and thirty-seven volunteers with no shoulder pain or history of shoulder injury were screened with ultrasonography bilaterally for rotator cuff tears and then underwent isometric strength measurements for abduction in the scapular plane and external rotation. Statistical analysis was performed to evaluate the effect of age, body habitus, hand dominance, and the presence of a rotator cuff tear on shoulder strength.
RESULTS: Of the 237 volunteers, forty-one were found to have a torn rotator cuff in at least one shoulder. The prevalence of rotator cuff tears was 0% for the subjects between forty and forty-nine years old; 10%, between fifty and fifty-nine years old; 20%, between sixty and sixty-nine years old; and 40.7% for those seventy years old or older. Both abduction strength and external rotation strength in the male subjects showed an age-dependent decrease, whereas only abduction strength showed an age-dependent decrease in the female subjects. In multiple regression analysis, age and weight were the most important predictors of abduction strength and external rotation strength, respectively. In the shoulders with a large-to-massive full-thickness rotator cuff tear, abduction strength was significantly decreased (p = 0.007). Additionally, the ratio of abduction strength to external rotation strength was significantly decreased in the shoulders with a large-to-massive full-thickness tear compared with the shoulders with an intact rotator cuff (p < 0.001).
CONCLUSIONS: There is a high prevalence of rotator cuff tears in elderly asymptomatic individuals. Asymptomatic shoulders with a large-to-massive full-thickness rotator cuff tear have significantly decreased abduction strength. When there is a substantial decrease in abduction strength in relation to external rotation strength, the presence of an asymptomatic full-thickness tear should be suspected in that shoulder. Previous studies establishing normative values for isometric shoulder strength may have been skewed by the presence of asymptomatic rotator cuff tears in elderly subgroups.

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Year:  2009        PMID: 19181972      PMCID: PMC2663343          DOI: 10.2106/JBJS.H.00219

Source DB:  PubMed          Journal:  J Bone Joint Surg Am        ISSN: 0021-9355            Impact factor:   5.284


  27 in total

Review 1.  Shoulder sonography. State of the art.

Authors:  S A Teefey; W D Middleton; K Yamaguchi
Journal:  Radiol Clin North Am       Date:  1999-07       Impact factor: 2.303

2.  Sonography of the rotator cuff: analysis of interobserver variability.

Authors:  William D Middleton; Sharlene A Teefey; Ken Yamaguchi
Journal:  AJR Am J Roentgenol       Date:  2004-11       Impact factor: 3.959

3.  A clinical method of functional assessment of the shoulder.

Authors:  C R Constant; A H Murley
Journal:  Clin Orthop Relat Res       Date:  1987-01       Impact factor: 4.176

4.  A comparative study of clinical muscle testing and Cybex evaluation after shoulder operations.

Authors:  S I Rabin; M Post
Journal:  Clin Orthop Relat Res       Date:  1990-09       Impact factor: 4.176

5.  Rotator-cuff changes in asymptomatic adults. The effect of age, hand dominance and gender.

Authors:  C Milgrom; M Schaffler; S Gilbert; M van Holsbeeck
Journal:  J Bone Joint Surg Br       Date:  1995-03

6.  Abnormal findings on magnetic resonance images of asymptomatic shoulders.

Authors:  J S Sher; J W Uribe; A Posada; B J Murphy; M B Zlatkin
Journal:  J Bone Joint Surg Am       Date:  1995-01       Impact factor: 5.284

7.  Normalization of the Constant score.

Authors:  Leonid I Katolik; Anthony A Romeo; Brian J Cole; Nikhil N Verma; Jennifer K Hayden; Bernard R Bach
Journal:  J Shoulder Elbow Surg       Date:  2005 May-Jun       Impact factor: 3.019

8.  Isometric strength in flexors, abductors, and external rotators of the shoulder.

Authors:  L Lannersten; K Harms-Ringdahl; K Schüldt; J Ekholm
Journal:  Clin Biomech (Bristol, Avon)       Date:  1993-09       Impact factor: 2.063

9.  Normative values for isometric muscle force measurements obtained with hand-held dynamometers.

Authors:  A W Andrews; M W Thomas; R W Bohannon
Journal:  Phys Ther       Date:  1996-03

10.  Isometric muscle strength and muscular endurance in normal persons aged between 17 and 70 years.

Authors:  E Bäckman; V Johansson; B Häger; P Sjöblom; K G Henriksson
Journal:  Scand J Rehabil Med       Date:  1995-06
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  44 in total

1.  Asymptomatic rotator cuff tears: patient demographics and baseline shoulder function.

Authors:  Jay D Keener; Karen Steger-May; Georgia Stobbs; Ken Yamaguchi
Journal:  J Shoulder Elbow Surg       Date:  2010-10-27       Impact factor: 3.019

2.  Artrhoscopic rotator cuff repair with augmentation: the V-sled technique.

Authors:  Claudio Chillemi; Stefano El Boustany; Luca Dei Giudici; Giorgio Ippolito
Journal:  Orthop Surg       Date:  2012-05       Impact factor: 2.071

3.  Progression of Fatty Muscle Degeneration in Atraumatic Rotator Cuff Tears.

Authors:  Jonah Hebert-Davies; Sharlene A Teefey; Karen Steger-May; Aaron M Chamberlain; William Middleton; Kathryn Robinson; Ken Yamaguchi; Jay D Keener
Journal:  J Bone Joint Surg Am       Date:  2017-05-17       Impact factor: 5.284

4.  In vivo shoulder function after surgical repair of a torn rotator cuff: glenohumeral joint mechanics, shoulder strength, clinical outcomes, and their interaction.

Authors:  Michael J Bey; Cathryn D Peltz; Kristin Ciarelli; Stephanie K Kline; George W Divine; Marnix van Holsbeeck; Stephanie Muh; Patricia A Kolowich; Terrence R Lock; Vasilios Moutzouros
Journal:  Am J Sports Med       Date:  2011-07-07       Impact factor: 6.202

5.  Validation of clinical examination versus magnetic resonance imaging and arthroscopy for the detection of rotator cuff lesions.

Authors:  Andrew J K Ostör; Christine A Richards; Graham Tytherleigh-Strong; Philip W Bearcroft; A Toby Prevost; Cathy A Speed; Brian L Hazleman
Journal:  Clin Rheumatol       Date:  2013-05-02       Impact factor: 2.980

6.  Tests for diagnosing subacromial impingement syndrome and rotator cuff disease.

Authors:  Nick Phillips
Journal:  Shoulder Elbow       Date:  2014-06-17

7.  Subacute effects of cervicothoracic spinal thrust/non-thrust in addition to shoulder manual therapy plus exercise intervention in individuals with subacromial impingement syndrome: a prospective, randomized controlled clinical trial pilot study.

Authors:  Alexis A Wright; Megan Donaldson; Craig A Wassinger; Alicia J Emerson-Kavchak
Journal:  J Man Manip Ther       Date:  2016-11-07

Review 8.  Alterations in tendon microenvironment in response to mechanical load: potential molecular targets for treatment strategies.

Authors:  Mohamed B Fouda; Finosh G Thankam; Matthew F Dilisio; Devendra K Agrawal
Journal:  Am J Transl Res       Date:  2017-10-15       Impact factor: 4.060

Review 9.  Clinical examination of the rotator cuff.

Authors:  Nitin B Jain; Reg B Wilcox; Jeffrey N Katz; Laurence D Higgins
Journal:  PM R       Date:  2013-01       Impact factor: 2.298

10.  Reference values for muscle strength: a systematic review with a descriptive meta-analysis.

Authors:  Poliana do Amaral Benfica; Larissa Tavares Aguiar; Sherindan Ayessa Ferreira de Brito; Luane Helena Nunes Bernardino; Luci Fuscaldi Teixeira-Salmela; Christina Danielli Coelho de Morais Faria
Journal:  Braz J Phys Ther       Date:  2018-05-03       Impact factor: 3.377

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