Infraspinatus Scapular Retraction Test: a Reliable and Practical Method to Assess Infraspinatus Strength in Overhead Athletes with Scapular Dyskinesis

Overview

Journal J Orthop Traumatol

Specialties Emergency Medicine
Orthopedics

Date 2010 Jun 2

PMID 20514507

Citations 7

Authors

Giovanni Merolla

Elisa De Santis

Fabrizio Campi

Paolo Paladini

Giuseppe Porcellini

Affiliations

Soon will be listed here.

Abstract

Background: Alteration of normal scapulohumeral rhythm due to the fatigue of scapular-stabilizing muscles induces decrease of rotator cuff strength. In this study we analyzed the interobserver and intraobserver realibility of the infraspinatus strength test (IST) and infraspinatus scapular retraction test (ISRT) in 29 overhead athletes with scapular dyskinesis, before and after 6 months of scapular musculature rehabilitation.

Materials And Methods: Subjects with magnetic resonance imaging (MRI) findings of labral injuries (2 cases, 5%) and cuff tears (4 cases, 11%) were excluded. Scapular dyskinesis patterns were evaluated according to Kibler et al. (J Shoulder Elbow Surg 11:550-556, 2002). We found a type I dyskinesis in 24 cases (83%) and a type II in 5 cases (17%). Patients were tested by using IST and ISRT and the maximum infraspinatus strength (kg) was registered by a handheld dynamometer. Changes in shoulder IR were measured by using a standard goniometry. Rehabilitation continued for 6 months and was focused on the restoration of scapular muscular control and balance. We used a paired Student t test for the significance of the force values (alpha = 0.01). Intraclass correlation coefficient (ICC) and standard error (SE) were applied to determine the realibility of repeated values collected within testers and between testers.

Results: Values of ICC close to 1 at baseline and at 6 months indicated a higher interexaminer and intraexaminer realibility. IST force values registered a significant increase at 6 months for both examiners (P < 0.01). The mean difference between IST and ISRT values were not significant at 6 months (P > 0.01). The increase of glenohumeral internal rotation was significant at 6 months (P < 0.01).

Conclusion: The good realibility and the easy reproducibility make the ISRT an excellent test to assess patients with infraspinatus weakness due to scapular dyskinesis and address them toward an appropriate program of rehabilitation aimed to restore scapular musculature balance and control.

Citing Articles

Diagnosis and Treatment of Snapping Scapula Syndrome: A Scoping Review.

Baldawi H, Gouveia K, Gohal C, Almana L, Paul R, Alolabi B Sports Health. 2021; 14(3):389-396.

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Scapular Dyskinesis: From Basic Science to Ultimate Treatment.

Longo U, Risi Ambrogioni L, Berton A, Candela V, Massaroni C, Carnevale A Int J Environ Res Public Health. 2020; 17(8).

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Functional outcomes and clinical strength assessment after infraspinatus-sparing surgical approach to scapular fracture: Does it really make a difference?.

Porcellini G, Palladini P, Congia S, Palmas A, Merolla G, Capone A J Orthop Traumatol. 2018; 19(1):15.

PMID: 30187145 PMC: 6125251. DOI: 10.1186/s10195-018-0509-8.

Rehabilitation for Shoulder Instability - Current Approaches.

Jaggi A, Alexander S Open Orthop J. 2017; 11:957-971.

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STRENGTH PROFILES IN HEALTHY INDIVIDUALS WITH AND WITHOUT SCAPULAR DYSKINESIS.

Hannah D, Scibek J, Carcia C Int J Sports Phys Ther. 2017; 12(3):305-313.

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References

Ben Kibler W, Uhl T, Maddux J, Brooks P, Zeller B, McMullen J . Qualitative clinical evaluation of scapular dysfunction: a reliability study. J Shoulder Elbow Surg. 2002; 11(6):550-6. DOI: 10.1067/mse.2002.126766. View

Ben Kibler W, Sciascia A, Dome D . Evaluation of apparent and absolute supraspinatus strength in patients with shoulder injury using the scapular retraction test. Am J Sports Med. 2006; 34(10):1643-7. DOI: 10.1177/0363546506288728. View

Rokito A, Jobe F, Pink M, Perry J, Brault J . Electromyographic analysis of shoulder function during the volleyball serve and spike. J Shoulder Elbow Surg. 1998; 7(3):256-63. DOI: 10.1016/s1058-2746(98)90054-4. View

Hawkins R, Kennedy J . Impingement syndrome in athletes. Am J Sports Med. 1980; 8(3):151-8. DOI: 10.1177/036354658000800302. View

Cools A, Witvrouw E, Declercq G, Vanderstraeten G, Cambier D . Evaluation of isokinetic force production and associated muscle activity in the scapular rotators during a protraction-retraction movement in overhead athletes with impingement symptoms. Br J Sports Med. 2004; 38(1):64-8. PMC: 1724756. DOI: 10.1136/bjsm.2003.004952. View

Escamilla R, Yamashiro K, Paulos L, Andrews J . Shoulder muscle activity and function in common shoulder rehabilitation exercises. Sports Med. 2009; 39(8):663-85. DOI: 10.2165/00007256-200939080-00004. View

McClure P, Michener L, Sennett B, Karduna A . Direct 3-dimensional measurement of scapular kinematics during dynamic movements in vivo. J Shoulder Elbow Surg. 2001; 10(3):269-77. DOI: 10.1067/mse.2001.112954. View

Merolla G, De Santis E, Sperling J, Campi F, Paladini P, Porcellini G . Infraspinatus strength assessment before and after scapular muscles rehabilitation in professional volleyball players with scapular dyskinesis. J Shoulder Elbow Surg. 2010; 19(8):1256-64. DOI: 10.1016/j.jse.2010.01.022. View

Escamilla R, Andrews J . Shoulder muscle recruitment patterns and related biomechanics during upper extremity sports. Sports Med. 2009; 39(7):569-90. DOI: 10.2165/00007256-200939070-00004. View

10.

David G, Magarey M, Jones M, Dvir Z, Turker K, Sharpe M . EMG and strength correlates of selected shoulder muscles during rotations of the glenohumeral joint. Clin Biomech (Bristol). 2000; 15(2):95-102. DOI: 10.1016/s0268-0033(99)00052-2. View

11.

Laudner K, Sipes R, Wilson J . The acute effects of sleeper stretches on shoulder range of motion. J Athl Train. 2008; 43(4):359-63. PMC: 2474815. DOI: 10.4085/1062-6050-43.4.359. View

12.

Smith J, Kotajarvi B, Padgett D, Eischen J . Effect of scapular protraction and retraction on isometric shoulder elevation strength. Arch Phys Med Rehabil. 2002; 83(3):367-70. DOI: 10.1053/apmr.2002.29666. View

13.

Burkhart S, Morgan C, Ben Kibler W . The disabled throwing shoulder: spectrum of pathology Part I: pathoanatomy and biomechanics. Arthroscopy. 2003; 19(4):404-20. DOI: 10.1053/jars.2003.50128. View

14.

Cools A, Dewitte V, Lanszweert F, Notebaert D, Roets A, Soetens B . Rehabilitation of scapular muscle balance: which exercises to prescribe?. Am J Sports Med. 2007; 35(10):1744-51. DOI: 10.1177/0363546507303560. View

15.

Happee R, van der Helm F . The control of shoulder muscles during goal directed movements, an inverse dynamic analysis. J Biomech. 1995; 28(10):1179-91. DOI: 10.1016/0021-9290(94)00181-3. View

16.

Rubin B, Ben Kibler W . Fundamental principles of shoulder rehabilitation: conservative to postoperative management. Arthroscopy. 2002; 18(9 Suppl 2):29-39. DOI: 10.1053/jars.2002.36507. View

17.

Smith J, Dietrich C, Kotajarvi B, Kaufman K . The effect of scapular protraction on isometric shoulder rotation strength in normal subjects. J Shoulder Elbow Surg. 2006; 15(3):339-43. DOI: 10.1016/j.jse.2005.08.023. View

18.

Johansen R, Callis M, Potts J, Shall L . A modified internal rotation stretching technique for overhand and throwing athletes. J Orthop Sports Phys Ther. 1995; 21(4):216-9. DOI: 10.2519/jospt.1995.21.4.216. View

19.

Leroux J, Thomas E, Bonnel F, Blotman F . Diagnostic value of clinical tests for shoulder impingement syndrome. Rev Rhum Engl Ed. 1995; 62(6):423-8. View

20.

Nakamizo H, Nakamura Y, Nobuhara K, Yamamoto T . Loss of glenohumeral internal rotation in little league pitchers: a biomechanical study. J Shoulder Elbow Surg. 2008; 17(5):795-801. DOI: 10.1016/j.jse.2008.02.013. View