Amaç: Çalışmanın amacı subakromiyal sıkışma sendromlu (SSS) hastalarda Constant Murley Skorlaması (CMS) ve Kol, Omuz ve El Sorunları Anketi (DASH) ile izometrik ve eksentrik omuz kuvveti arasındaki ilişkiyi araştırmaktı.
Yöntem: Çalışmaya SSS’li 34 hasta alındı. Abduksiyon kuvveti 90o abduksiyonda izometrik ve 120-30° abduksiyon arasında eksentrik olarak ölçüldü. Eksternal rotasyon (ER) kuvveti 90o abduksiyon ve 90° ER pozisyonunda izometrik ve aynı pozisyonda 90 ER ve nötral rotasyon arasında eksentrik olarak el dinamometresi ile ölçüldü. Omuz fonksiyonu CMS ve DASH ile değerlendirildi.
Bulgular: CMS skoru ile izometrik ve eksentrik abduksiyon ve izometrik ve eksentrik ER kuvveti arasında pozitif yönde orta-iyi arası düzeyde değişen ilişki bulundu (p<0.05). CMS günlük yaşam aktiviteleri alt skoru ile izometrik abduksiyon ve ER, eklem hareket açıklığı (EHA) alt skoru ile yalnızca izometrik abduksiyon (kuvveti arasında orta derecede ilişki vardı (p<0.05). CMS kuvvet alt skoru ile izometrik ve eksentrik abduksiyon kuvveti ve izometrik ve eksentrik ER kuvveti arasında iyi-mükemmel arası düzeyde değişen ilişki bulundu (p<0.05). Diğer parametreler arasında anlamlı ilişki yoktu (p>0.05).
Sonuç: SSS’li hastalarda omuz izometrik ve eksentrik kuvveti azaldıkça CMS skoru ve dolayısıyla fonksiyon azalmakta, DASH skoru ise değişmemektedir. Bu hastalarda CMS omuz kas kuvveti ile, daha çok izometrik kas kuvveti ile ilişkili fonksiyonel kayıpları yansıtmakta, DASH ise bu konuda yetersiz kalmaktadır.
1. Dong W, Goost H, Lin XB, et al. Treatments for shoulder impingement syndrome: a PRISMA systematic review and network meta-analysis. Medicine (Baltimore). 2015;94:e510.
2. Huang H, Grant JA, Miller BS, et al. A Systematic Review of the Psychometric Properties of Patient-Reported Outcome Instruments for Use in Patients With Rotator Cuff Disease. Am J Sports Med. 2015;43:2572-2582.
3. Land H, Gordon S, Watt K. Isokinetic clinical assessment of rotator cuff strength in subacromial shoulder impingement. Musculoskelet Sci Pract. 2017;27:32-39.
4. Makhni EC, Steinhaus ME, Morrow ZS, et al. Outcomes assessment in rotator cuff pathology: what are we measuring? J Shoulder Elbow Surg. 2015;24:2008-2015.
5. Roddey TS, Cook KF, O'Malley KJ, et al. The relationship among strength and mobility measures and self-report outcome scores in persons after rotator cuff repair surgery: impairment measures are not enough. J Shoulder Elbow Surg. 2005;14:S95-S98.
6. Beissner KL, Collins JE, Holmes H. Muscle force and range of motion as predictors of function in older adults. Phys Ther. 2000;80:556-563.
7. Thoomes-de Graaf M, Scholten-Peeters GG, Schellingerhout JM, et al. Evaluation of measurement properties of self-administered PROMs aimed at patients with non-specific shoulder pain and "activity limitations": a systematic review. Qual Life Res. 2016;25:2141-2160.
8. Basar S, Citaker S, Kanatli U, et al. Assessment of function in patients with rotator cuff tears: Functional test versus self-reported questionnaire. Int J Shoulder Surg. 2014;8:107-113.
9. Razmjou H, Bean A, Macdermid JC, et al. Convergent validity of the constant-murley outcome measure in patients with rotator cuff disease. Physiother Can. 2008;60:72-79.
10. Clausen MB, Witten A, Holm K, et al. Glenohumeral and scapulothoracic strength impairments exists in patients with subacromial impingement, but these are not reflected in the shoulder pain and disability index. BMC Musculoskelet Disord. 2017;18:302.
11. Vidt ME, Santago AC 2nd, Hegedus EJ, et al. Can self-report instruments of shoulder function capture functional differences in older adults with and without a rotator cuff tear? J Electromyogr Kinesiol. 2016;29:90-99.
12. Lopes AD, Ciconelli RM, Carrera EF, et al. Validity and reliability of the Western Ontario Rotator Cuff Index (WORC) for use in Brazil. Clin J Sport Med. 2008;18:266-272.
13. MacDermid JC, Ramos J, Drosdowech D, et al. The impact of rotator cuff pathology on isometric and isokinetic strength, function, and quality of life. J Shoulder Elbow Surg. 2004;13:593-598.
14. Amiridis IG, Cometti G, Morlon B, et al. Concentric and/or eccentric training-induced alterations in shoulder flexor and extensor strength. J Orthop Sports Phys Ther. 1997;25:26-33.
15. Ortega-Castillo M, Medina-Porqueres I. Effectiveness of the eccentric exercise therapy in physically active adults with symptomatic shoulder impingement or lateral epicondylar tendinopathy: A systematic review. J Sci Med Sport. 2016;19:438-453.
16. Angst F, Schwyzer HK, Aeschlimann A, et al. Measures of adult shoulder function: Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and its short version (QuickDASH), Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) Society standardized shoulder assessment form, Constant (Murley) Score (CS), Simple Shoulder Test (SST), Oxford Shoulder Score (OSS), Shoulder Disability Questionnaire (SDQ), and Western Ontario Shoulder Instability Index (WOSI). Arthritis Care Res. 2011;63:S174-S188.
17. Roy JS, MacDermid JC, Woodhouse LJ. Measuring shoulder function: a systematic review of four questionnaires. Arthritis and rheumatism. 2009;61:623-632.
18. Roy JS, Macdermid JC, Boyd KU, et al. Rotational strength, range of motion, and function in people with unaffected shoulders from various stages of life. Sports Med Arthrosc Rehabil Ther Technol. 2009;1:4.
19. Constant CR, Gerber C, Emery RJ, et al. A review of the Constant score: modifications and guidelines for its use. J Shoulder Elbow Surg. 2008;17:355-361.
20. Michener LA, Walsworth MK, Doukas WC, et al. Reliability and diagnostic accuracy of 5 physical examination tests and combination of tests for subacromial impingement. Arch Phys Med Rehabil. 2009;90:1898-1903.
21. Cools AM, De Wilde L, Van Tongel A, et al. Measuring shoulder external and internal rotation strength and range of motion: comprehensive intra-rater and inter-rater reliability study of several testing protocols. J Shoulder Elbow Surg. 2014;23:1454-1461.
22. Johansson FR, Skillgate E, Lapauw ML, et al. Measuring eccentric strength of the shoulder external rotators using a handheld dynamometer: reliability and validity. J Athl Train. 2015;50:719-725.
23. Hayes K, Walton JR, Szomor ZL, et al. Reliability of 3 methods for assessing shoulder strength. J Shoulder Elbow Surg. 2002;11:33-39.
24. Celik D. Turkish version of the modified Constant-Murley score and standardized test protocol: reliability and validity. Acta Orthop Traumatol Turc. 2016;50:69-75.
25. Düger T, Yakut E, Öksüz Ç, et al. Kol, omuz ve el sorunları (disabilities of the arm, shoulder and hand-DASH) anketi Türkçe uyarlamasının güvenirliği ve geçerliği. Türk Fizyoterapi ve Rehabilitasyon Dergisi. 2006;17:99-107.
26. Harrington S, Padua D, Battaglini C, et al. Upper extremity strength and range of motion and their relationship to function in breast cancer survivors. Physiother Theory Pract. 2013;29:513-520.
The relationship between isometric and eccentric shoulder strength with commonly used shoulder function scales in patients with subacromial impingement syndrome
Year 2019,
Volume: 6 Issue: 3, 163 - 170, 10.01.2020
Purpose: The aim of this study was to investigate the relationship between isometric and eccentric shoulder muscle strength with Disabilities of Arm, Shoulder and Hand (DASH) questionnaire and Constant Murley Score (CMS) scales in patients with subacromial impingement syndrome (SIS).
Methods: Thirty-four patients with SIS were included. The abduction strength was measured isometrically in 90° abduction and eccentrically in 120-30° abduction, and external rotation (ER) strength was measured isometrically in 90° abduction-90° ER and eccentrically from 90° ER to neutral rotation using a handheld dynamometer. Shoulder function was assessed by CMS and DASH questionnaire.
Results: There were positive moderate-good correlations between CMS and isometric and eccentric abduction strength and isometric and eccentric ER strength (p<0.05). There was a moderate correlation between CMS activities of daily living sub-score and isometric abduction and ER strength, between range of motion sub-score and isometric abduction strength (p<0.05). CMS strength sub-score was good to excellent correlated with the isometric and eccentric abduction strength and isometric and eccentric ER strength (p<0.05). There were no significant correlations between other parameters (p>0.05).
Conclusion: The DASH score is stable while shoulder isometric and eccentric strength decreased accompanying with low CMS score and function in patient with SIS. The CMS reflects functional loss related to muscle strength, especially isometric strength. DASH questionnaire is insufficient in this regard.
1. Dong W, Goost H, Lin XB, et al. Treatments for shoulder impingement syndrome: a PRISMA systematic review and network meta-analysis. Medicine (Baltimore). 2015;94:e510.
2. Huang H, Grant JA, Miller BS, et al. A Systematic Review of the Psychometric Properties of Patient-Reported Outcome Instruments for Use in Patients With Rotator Cuff Disease. Am J Sports Med. 2015;43:2572-2582.
3. Land H, Gordon S, Watt K. Isokinetic clinical assessment of rotator cuff strength in subacromial shoulder impingement. Musculoskelet Sci Pract. 2017;27:32-39.
4. Makhni EC, Steinhaus ME, Morrow ZS, et al. Outcomes assessment in rotator cuff pathology: what are we measuring? J Shoulder Elbow Surg. 2015;24:2008-2015.
5. Roddey TS, Cook KF, O'Malley KJ, et al. The relationship among strength and mobility measures and self-report outcome scores in persons after rotator cuff repair surgery: impairment measures are not enough. J Shoulder Elbow Surg. 2005;14:S95-S98.
6. Beissner KL, Collins JE, Holmes H. Muscle force and range of motion as predictors of function in older adults. Phys Ther. 2000;80:556-563.
7. Thoomes-de Graaf M, Scholten-Peeters GG, Schellingerhout JM, et al. Evaluation of measurement properties of self-administered PROMs aimed at patients with non-specific shoulder pain and "activity limitations": a systematic review. Qual Life Res. 2016;25:2141-2160.
8. Basar S, Citaker S, Kanatli U, et al. Assessment of function in patients with rotator cuff tears: Functional test versus self-reported questionnaire. Int J Shoulder Surg. 2014;8:107-113.
9. Razmjou H, Bean A, Macdermid JC, et al. Convergent validity of the constant-murley outcome measure in patients with rotator cuff disease. Physiother Can. 2008;60:72-79.
10. Clausen MB, Witten A, Holm K, et al. Glenohumeral and scapulothoracic strength impairments exists in patients with subacromial impingement, but these are not reflected in the shoulder pain and disability index. BMC Musculoskelet Disord. 2017;18:302.
11. Vidt ME, Santago AC 2nd, Hegedus EJ, et al. Can self-report instruments of shoulder function capture functional differences in older adults with and without a rotator cuff tear? J Electromyogr Kinesiol. 2016;29:90-99.
12. Lopes AD, Ciconelli RM, Carrera EF, et al. Validity and reliability of the Western Ontario Rotator Cuff Index (WORC) for use in Brazil. Clin J Sport Med. 2008;18:266-272.
13. MacDermid JC, Ramos J, Drosdowech D, et al. The impact of rotator cuff pathology on isometric and isokinetic strength, function, and quality of life. J Shoulder Elbow Surg. 2004;13:593-598.
14. Amiridis IG, Cometti G, Morlon B, et al. Concentric and/or eccentric training-induced alterations in shoulder flexor and extensor strength. J Orthop Sports Phys Ther. 1997;25:26-33.
15. Ortega-Castillo M, Medina-Porqueres I. Effectiveness of the eccentric exercise therapy in physically active adults with symptomatic shoulder impingement or lateral epicondylar tendinopathy: A systematic review. J Sci Med Sport. 2016;19:438-453.
16. Angst F, Schwyzer HK, Aeschlimann A, et al. Measures of adult shoulder function: Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and its short version (QuickDASH), Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) Society standardized shoulder assessment form, Constant (Murley) Score (CS), Simple Shoulder Test (SST), Oxford Shoulder Score (OSS), Shoulder Disability Questionnaire (SDQ), and Western Ontario Shoulder Instability Index (WOSI). Arthritis Care Res. 2011;63:S174-S188.
17. Roy JS, MacDermid JC, Woodhouse LJ. Measuring shoulder function: a systematic review of four questionnaires. Arthritis and rheumatism. 2009;61:623-632.
18. Roy JS, Macdermid JC, Boyd KU, et al. Rotational strength, range of motion, and function in people with unaffected shoulders from various stages of life. Sports Med Arthrosc Rehabil Ther Technol. 2009;1:4.
19. Constant CR, Gerber C, Emery RJ, et al. A review of the Constant score: modifications and guidelines for its use. J Shoulder Elbow Surg. 2008;17:355-361.
20. Michener LA, Walsworth MK, Doukas WC, et al. Reliability and diagnostic accuracy of 5 physical examination tests and combination of tests for subacromial impingement. Arch Phys Med Rehabil. 2009;90:1898-1903.
21. Cools AM, De Wilde L, Van Tongel A, et al. Measuring shoulder external and internal rotation strength and range of motion: comprehensive intra-rater and inter-rater reliability study of several testing protocols. J Shoulder Elbow Surg. 2014;23:1454-1461.
22. Johansson FR, Skillgate E, Lapauw ML, et al. Measuring eccentric strength of the shoulder external rotators using a handheld dynamometer: reliability and validity. J Athl Train. 2015;50:719-725.
23. Hayes K, Walton JR, Szomor ZL, et al. Reliability of 3 methods for assessing shoulder strength. J Shoulder Elbow Surg. 2002;11:33-39.
24. Celik D. Turkish version of the modified Constant-Murley score and standardized test protocol: reliability and validity. Acta Orthop Traumatol Turc. 2016;50:69-75.
25. Düger T, Yakut E, Öksüz Ç, et al. Kol, omuz ve el sorunları (disabilities of the arm, shoulder and hand-DASH) anketi Türkçe uyarlamasının güvenirliği ve geçerliği. Türk Fizyoterapi ve Rehabilitasyon Dergisi. 2006;17:99-107.
26. Harrington S, Padua D, Battaglini C, et al. Upper extremity strength and range of motion and their relationship to function in breast cancer survivors. Physiother Theory Pract. 2013;29:513-520.
Karabay D, Erduran M, Özcan C, Yeşilyaprak SS. Subakromiyal sıkışma sendromu olan hastalarda omuzda sık kullanılan fonksiyon ölçekleri ile izometrik ve eksentrik omuz kuvveti arasındaki ilişki. JETR. 2020;6(3):163-70.