Muscle strength measurements reflecting the extent of complete subscapularis tears: reliability in patients with rotator cuff tears

Sahara, Wataru; Takagi, Keishi; Tada, Shuhei; Yamada, Daichi; Kiya, Hiroki; Hanai, Hiroto; Konda, Shoji; Okada, Seiji

doi:https://doi.org/10.1016/j.jseint.2024.08.201

Muscle strength measurements reflecting the extent of complete subscapularis tears: reliability in patients with rotator cuff tears

Sahara, Wataru; Takagi, Keishi; Tada, Shuhei et al.

JSES International, 2025, 9(1), 109-115

Number of Access:736（2025-07-24 02:15 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/101100

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Title	Muscle strength measurements reflecting the extent of complete subscapularis tears: reliability in patients with rotator cuff tears
Creator	NRID 1000080706391 1000080706391 ORCID 0000-0002-3597-4388 0000-0002-3597-4388 researchmap permalink _ws _ws Scopus Author ID 6506069419 6506069419 CreatorName Sahara, Wataru
	CreatorName Takagi, Keishi
	CreatorName Tada, Shuhei
	NRID 1000060858562 1000060858562 CreatorName Yamada, Daichi
	CreatorName Kiya, Hiroki
	NRID 1000090964437 1000090964437 CreatorName Hanai, Hiroto
	NRID 1000080598227 1000080598227 ORCID 0000-0002-8252-7281 0000-0002-8252-7281 researchmap permalink read0153426 read0153426 Scopus Author ID 36447423200 36447423200 CreatorName Konda, Shoji
	NRID 1000030448435 1000030448435 ORCID 0000-0002-5107-8209 0000-0002-5107-8209 researchmap permalink okadaseiji okadaseiji Scopus Author ID 35079139100 35079139100 CreatorName Okada, Seiji
Subject	Diagnostic Study
	Level II
	Measurement error
	Muscle strength
	Patients
	Reliability
	Rotator cuff tears
	Subscapularis
Description	Sahara W., Takagi K., Tada S., et al. Muscle strength measurements reflecting the extent of complete subscapularis tears: reliability in patients with rotator cuff tears. JSES International 9, 109 (2025); https://doi.org/10.1016/j.jseint.2024.08.201.
Abstract	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.
Publisher	Elsevier B.V.
Source Title	JSES International
Volume (Issue)	9(1)
Page	109-115
Date of Issued	2025-01-11
Language	English
Handle URL	https://hdl.handle.net/11094/101100
eISSN	26666383
Relation.isSupplementedBy	HDL https://hdl.handle.net/11094/101101
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1016/j.jseint.2024.08.201
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	JSES International. 2025, 9(1), p. 109-115
DC.title	Muscle strength measurements reflecting the extent of complete subscapularis tears: reliability in patients with rotator cuff tears
DC.creator	Sahara, Wataru
	Takagi, Keishi
	Tada, Shuhei
	Yamada, Daichi
	Kiya, Hiroki
	Hanai, Hiroto
	Konda, Shoji
	Okada, Seiji
DC.publisher	Elsevier B.V.
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2025-01-11
DC.identifier	https://doi.org/10.1016/j.jseint.2024.08.201
DC.identifier' scheme='DCTERMS.URI	https://hdl.handle.net/11094/101101
DC.subject	Diagnostic Study
	Level II
	Measurement error
	Muscle strength
	Patients
	Reliability
	Rotator cuff tears
	Subscapularis
DC.description	Sahara W., Takagi K., Tada S., et al. Muscle strength measurements reflecting the extent of complete subscapularis tears: reliability in patients with rotator cuff tears. JSES International 9, 109 (2025); https://doi.org/10.1016/j.jseint.2024.08.201.
DCTERMS.abstract	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.
DC.rights	This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
DC.format	101100
citation_title	Muscle strength measurements reflecting the extent of complete subscapularis tears: reliability in patients with rotator cuff tears
citation_author	Sahara, Wataru
	Takagi, Keishi
	Tada, Shuhei
	Yamada, Daichi
	Kiya, Hiroki
	Hanai, Hiroto
	Konda, Shoji
	Okada, Seiji
citation_publisher	Elsevier B.V.
citation_language	English
citation_date	2025-01-11
citation_journal_title	JSES International
citation_volume	9
citation_issue	1
citation_firstpage	109
citation_lastpage	115
citation_doi	https://doi.org/10.1016/j.jseint.2024.08.201
citation_public_url	https://hdl.handle.net/11094/101100

Muscle strength measurements reflecting the extent of complete subscapularis tears: reliability in patients with rotator cuff tears

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