ASSESSMENT OF ISOKINETIC AND HAND-HELD DYNAMOMETER MEASURES OF SHOULDER ROTATOR STRENGTH AMONG INDIVIDUALS WITH SPINAL-CORD INJURY

Objective: To determine the intrarater reliability of the hand-held dy namometer (HHD) for the measurement of shoulder rotation and to examin e the relationship between the peak force values of the HHD and the is okinetic dynamometer. Participants: Twenty-five spinal cord injured in dividuals, 12 persons with paraplegia and 13 persons with tetraplegia between the ages of 18 and 42 years, were recruited from the community . Setting: Private practice clinic. Procedures: All participants were tested with the HHD by one examiner to determine reliability. On the s ame day, these participants underwent isokinetic testing to determine the relationship of the HHD and Cybex dynamometer measurements. Result s: The intraclass correlation coefficients for the intrarater reliabil ity ranged from .89 to .96. The Pearson product moment correlation was used to analyze the relationship between the two devices. All coeffic ients (.52 to .88) were statistically significant (p < .01); however, Separate analyses for the persons with paraplegia and tetraplegia diff ered considerably. There was substantial variability of the isokinetic strength values at the lower levels of isometric strength. Conclusion s: The HHD can be used reliably to measure shoulder rotation in parapl egic and tetraplegic spinal cord injured individuals. Although it appe ars that the relationship between HHD and isokinetic measurement is po or for the participants with tetraplegia, the variability of the isoki netic scores indicates that this observation may be a function of the method of isokinetic measurements. Further study with a modified isoki netic testing protocol is needed to clarify the results of the partici pants with tetraplegia. (C) 1997 by the American Congress of Rehabilit ation Medicine and the American Academy of Physical Medicine and Rehab ilitation.