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：开发一种可行的方案来测试四肢瘫痪轮椅运动员的最大肩部旋转力量，并研究最大等长手持测功机（HHD）对最大等速测功机（ID）力量测量的同时有效性；其次，研究最大肩部旋转测量期间肩部肌肉的激活，以及肩部力量和肩部疼痛之间的关联。

设计：描述性方法。

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

参与者：十二名成人四肢瘫痪者。

干预措施：不适用。

结果测量：轮椅使用者的肩部疼痛指数 (WUSPI) 和视觉模拟量表 (VAS) 测量肩部疼痛，等距 HHD 和 ID (60°/s) 测量最大内部 (IR) 和外部 (ER) 肩部旋转强度。表面肌电图标准化为最大肩部旋转强度期间测量的最大肌电图测量的肌肉活动（毫米冈下肌和背阔肌）。

结果：等长 HHD 对 ID 的同时有效性显示左右臂的一致性相关系数分别为 0.90 和 0.86（IR）以及 0.89 和 0.91（ER），等长 HHD 和 ID 之间的肌肉活动没有差异，但共激活更大急诊室期间。除了左臂和右臂 ID 与 ER 期间疼痛之间显着微弱的负相关性外，肩部力量与疼痛之间没有相关性（P  = 0.03；P  = 0.04）。

结论：为四肢瘫痪轮椅运动员测量最大肩部旋转力量建立了标准化可行的方案。等距 HHD 在归一化峰值扭矩和肌肉活动方面与 ID 相当，但具有更大的共同激活。力量与肩部疼痛没有明显关联。