Objective: To develop a feasible protocol for testing maximum shoulder rotation strength in tetraplegic wheelchair athletes, and investigate concurrent validity of maximum isometric handheld dynamometer (HHD) towards maximum isokinetic dynamometer (ID) strength measurements; secondly, to study shoulder muscle activation during maximum shoulder rotation measurements, and the association between shoulder strength and shoulder pain.

Design: Descriptive methodological.

Setting: Danish Wheelchair Rugby (WCR) association for WCR tetraplegic athletes from local WCR-clubs.

Participants: Twelve adult tetraplegics.

Interventions: N/A.

Outcome measures: Wheelchair User's Shoulder Pain Index (WUSPI) and Visual Analog Scale (VAS) measured shoulder pain, isometric HHD and ID (60°/s) measured maximum internal (IR) and external (ER) shoulder rotation strength. Surface Electromyography normalized to maximum EMG measured muscle activity (mm Infraspinatus and Latissimus Dorsi) during maximum shoulder rotation strength.

Results: Concurrent validity of isometric HHD towards ID showed Concordance Correlation Coefficients of left and right arms 0.90 and 0.86 (IR), and 0.89 and 0.91 (ER), with no difference in muscle activity between isometric HHD and ID, but larger co-activation during ER. There was no association between shoulder strength and pain, except for significantly weak negative associations between ID and pain during ER for left and right arms (P = 0.03; P = 0.04).

Conclusion: Standardized feasible protocol for tetraplegic wheelchair athletes for measuring maximum shoulder rotation strength was established. Isometric HHD is comparable with ID on normalized peak torques and muscle activity, but with larger co-activation. Strength was not clearly associated with shoulder pain.

目的：制定测试四肢瘫痪轮椅运动员最大肩旋转强度的可行方案，并探讨最大等距手持测功机（HHD）对最大等速测功机（ID）强度测量的同时有效性；其次，研究在最大肩旋转测量过程中肩部肌肉的激活以及肩部力量与肩部疼痛之间的关系。

设计：描述性方法论。

地点：丹麦轮椅橄榄球协会（WCR），用于来自当地WCR俱乐部的WCR四肢瘫痪运动员。

参加者：十二名成人四肢瘫痪者。

干预措施： N / A。

结果指标：轮椅使用者的肩膀疼痛指数（WUSPI）和视觉模拟量表（VAS）测量了肩膀疼痛，等距HHD和ID（60°/ s）测量了最大内部（IR）和外部（ER）肩膀旋转强度。表面肌电图标准化为最大肌电图测得的最大肩关节旋转强度期间的肌肉活动（毫米Infraspinatus和Latissimus Dorsi）。

结果：等距HHD对ID的并发有效性显示左臂和右臂的一致性相关系数分别为0.90和0.86（IR），0.89和0.91（ER），等距HHD和ID之间的肌肉活动没有差异，但共激活较大在急诊期间。肩部力量与疼痛之间没有关联，除了左右臂内测期间ID与疼痛之间的显着弱负相关（P  = 0.03； P  = 0.04）。

结论：建立了四肢瘫痪轮椅运动员测量最大肩旋转强度的标准可行方案。等距HHD在归一化峰值扭矩和肌肉活动方面与ID相当，但具有更大的共激活性。力量并没有明显与肩痛相关。