Standardized Isokinetic Testing Protocol for the Throwing Shoulder: The Throwers' Series

Article type: Research Article

Authors: Wilk, Kevin E.^{a; *; **} | Arrigo, Christopher A.^{a; ***} | Andrews, James R.^{a; ***}

Affiliations: [a] Healthsouth Sports Medicine & Rehabilitation Center, the Alabama Sports Medicine & Orthopaedic Center, and the American Sports Medicine Institute

Note: [*] Director of Clinical Services, Healthsouth Sports Medicine & Rehabilitation, Birmingham, AL; Director of Rehabilitative Research, American Sports Medicine Institute, Birmingham, AL.

Note: [**] Address reprint requests to Kevin E. Wilk, PT, Clinical Director, at the Healthsouth Sports Medicine & Rehabilitation, 1222 14th Avenue South, Suite 212, Birmingham, AL 35205.

Note: [***] Healthsouth Sports Medicine & Rehabilitation, Birmingham, AL.

Abstract: The purpose of this paper is to present a reproducible, sport-specific, and functional method for isokinetic evaluation of the throwing shoulder. Fifteen guidelines for standardization of isokinetic shoulder testing are identified and discussed, including: (1) planes of motion to evaluate, (2) testing positions and stabilization, (3) axis of joint motion, (4) client education, (5) active warm-up, (6) gravity compensation, (7) rest intervals, (8) initial contralateral extremity testing, (9) standard of verbal commands, (10) standard visual feedback, (11) testing velocities utilized, (12) test repetitions to perform, (13) proper system calibration, (14) insuring that the system is level and stabilized, and (15) the use of windowed data and a semi-hard (firm) end stop during testing. This Throwers' Series testing protocol outlines isokinetic testing at 180, 300, and 450 deg/sec in two planes: (1) internal rotation/external rotation (tR/ER) in 90 deg of shoulder abduction and 90 deg of elbow flexion, and (2) seated abduction/adduction. Following an active warmup, athletes perform 10 repetitions at 180 deg/sec, 15 repetitions at 300 deg/sec, and 10 repetitions at 450 deg/sec. IR/ER and the nondominant extremity are always evaluated first to standardize testing order. Fifteen parameters for interpretation of isokinetic test results of the throwing shoulder are outlined, with emphasis placed on the use of windowed data and a firm end stop to minimize endpoint oscillation torque spikes and misinterpretation of data. This paper offers clinical relevance by outlining an objective, reproducible, and standard method to evaluate the muscular performance of the throwing shoulder. These methods are designed to minimize variability and enhance interclinician communication regarding isokinetic shoulder test data and interpretation.

Keywords: Isokinetic testing, standardization, objective test data, shoulder abduction/adduction and internal/external rotation, throwers

DOI: 10.3233/IES-1991-1202

Journal: Isokinetics and Exercise Science, vol. 1, no. 2, pp. 63-71, 1991