Muscle strength measurements reflecting the extent of complete subscapularis tears: reliability in patients with rotator cuff tears
Background: While several clinical tests for diagnosing subscapularis (SSC) tears have been reported, no quantitative method reflecting tear size has been established. This study investigated muscle strength measurements that best reflect the extent of SSC tears and clarified their reliability. Meth...
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Elsevier
2025-01-01
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| author | Wataru Sahara, MD, PhD Keishi Takagi, PT Shuhei Tada, PT Daichi Yamada, PT Hiroki Kiya, PT Hiroto Hanai, MD, PhD Shoji Konda, PhD Seiji Okada, MD, PhD |
| author_facet | Wataru Sahara, MD, PhD Keishi Takagi, PT Shuhei Tada, PT Daichi Yamada, PT Hiroki Kiya, PT Hiroto Hanai, MD, PhD Shoji Konda, PhD Seiji Okada, MD, PhD |
| author_sort | Wataru Sahara, MD, PhD |
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| description | Background: While several clinical tests for diagnosing subscapularis (SSC) tears have been reported, no quantitative method reflecting tear size has been established. This study investigated muscle strength measurements that best reflect the extent of SSC tears and clarified their reliability. Methods: We analyzed 107 patients (111 shoulders) who underwent arthroscopic surgery for rotator cuff tears, assessing preoperative and postoperative muscle strength. Isometric internal rotation strength was measured by using a handheld dynamometer using three techniques: the belly-press, Napoleon, and bear-hug techniques. The correlation between the extent of complete SSC tears and preoperative strength for each technique was assessed using Spearman’s rank correlation coefficient. Intrarater reliability was assessed using the intraclass correlation coefficient (ICC) (1, 3), minimal detectable change (MDC), and MDC% based on three preoperative measurements on the operated side. Test-retest reliability was evaluated using these parameters from measurements on the nonoperated side preoperatively and at 6- and 12-month postoperative intervals. Results: The correlation coefficient between the extent of SSC tears and the strength of each muscle was approximately −0.45 for all techniques, indicating a weak negative correlation. The intrarater reliability for all techniques showed ICC (1, 3) >0.95, MDC <10 N, and MDC% of approximately 10%. The Napoleon technique demonstrated the highest test-retest reliability, with ICC (3, 1) of 0.87, MDC of 17 N, and MDC% of 21%. Conclusion: The Napoleon technique provided more stable muscle exertion than the other methods. The results may aid in determining whether postoperative muscle strength recovery falls within the range of measurement error. |
| format | Article |
| id | doaj-art-c98c958042d24db2bbf8f62f4df39357 |
| institution | Kabale University |
| issn | 2666-6383 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES International |
| spelling | doaj-art-c98c958042d24db2bbf8f62f4df393572025-01-12T05:26:01ZengElsevierJSES International2666-63832025-01-0191109115Muscle strength measurements reflecting the extent of complete subscapularis tears: reliability in patients with rotator cuff tearsWataru Sahara, MD, PhD0Keishi Takagi, PT1Shuhei Tada, PT2Daichi Yamada, PT3Hiroki Kiya, PT4Hiroto Hanai, MD, PhD5Shoji Konda, PhD6Seiji Okada, MD, PhD7Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita city, Osaka, Japan; Department of Rehabilitation, Osaka University Hospital, Suita city, Osaka, Japan; Corresponding author: Wataru Sahara, MD, PhD, Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita city, Osaka 565-0871, Japan.Department of Rehabilitation, Osaka University Hospital, Suita city, Osaka, JapanDepartment of Rehabilitation, Osaka University Hospital, Suita city, Osaka, JapanDepartment of Rehabilitation, Osaka University Hospital, Suita city, Osaka, JapanDepartment of Rehabilitation, Osaka University Hospital, Suita city, Osaka, JapanDepartment of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita city, Osaka, JapanDepartment of Health and Sport Sciences, Osaka University Graduate School of Medicine, Toyonaka city, Osaka, JapanDepartment of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita city, Osaka, JapanBackground: While several clinical tests for diagnosing subscapularis (SSC) tears have been reported, no quantitative method reflecting tear size has been established. This study investigated muscle strength measurements that best reflect the extent of SSC tears and clarified their reliability. Methods: We analyzed 107 patients (111 shoulders) who underwent arthroscopic surgery for rotator cuff tears, assessing preoperative and postoperative muscle strength. Isometric internal rotation strength was measured by using a handheld dynamometer using three techniques: the belly-press, Napoleon, and bear-hug techniques. The correlation between the extent of complete SSC tears and preoperative strength for each technique was assessed using Spearman’s rank correlation coefficient. Intrarater reliability was assessed using the intraclass correlation coefficient (ICC) (1, 3), minimal detectable change (MDC), and MDC% based on three preoperative measurements on the operated side. Test-retest reliability was evaluated using these parameters from measurements on the nonoperated side preoperatively and at 6- and 12-month postoperative intervals. Results: The correlation coefficient between the extent of SSC tears and the strength of each muscle was approximately −0.45 for all techniques, indicating a weak negative correlation. The intrarater reliability for all techniques showed ICC (1, 3) >0.95, MDC <10 N, and MDC% of approximately 10%. The Napoleon technique demonstrated the highest test-retest reliability, with ICC (3, 1) of 0.87, MDC of 17 N, and MDC% of 21%. Conclusion: The Napoleon technique provided more stable muscle exertion than the other methods. The results may aid in determining whether postoperative muscle strength recovery falls within the range of measurement error.http://www.sciencedirect.com/science/article/pii/S2666638324003931Muscle strengthSubscapularisRotator cuff tearsPatientsReliabilityMeasurement error |
| spellingShingle | Wataru Sahara, MD, PhD Keishi Takagi, PT Shuhei Tada, PT Daichi Yamada, PT Hiroki Kiya, PT Hiroto Hanai, MD, PhD Shoji Konda, PhD Seiji Okada, MD, PhD Muscle strength measurements reflecting the extent of complete subscapularis tears: reliability in patients with rotator cuff tears JSES International Muscle strength Subscapularis Rotator cuff tears Patients Reliability Measurement error |
| title | Muscle strength measurements reflecting the extent of complete subscapularis tears: reliability in patients with rotator cuff tears |
| title_full | Muscle strength measurements reflecting the extent of complete subscapularis tears: reliability in patients with rotator cuff tears |
| title_fullStr | Muscle strength measurements reflecting the extent of complete subscapularis tears: reliability in patients with rotator cuff tears |
| title_full_unstemmed | Muscle strength measurements reflecting the extent of complete subscapularis tears: reliability in patients with rotator cuff tears |
| title_short | Muscle strength measurements reflecting the extent of complete subscapularis tears: reliability in patients with rotator cuff tears |
| title_sort | muscle strength measurements reflecting the extent of complete subscapularis tears reliability in patients with rotator cuff tears |
| topic | Muscle strength Subscapularis Rotator cuff tears Patients Reliability Measurement error |
| url | http://www.sciencedirect.com/science/article/pii/S2666638324003931 |
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