JORR
Journal of Orthopedics Research and Rehabilitation

The Journal of Orthopedics Research and Rehabilitation welcomes scholarly papers inorthopaedic surgery, physical therapy and rehabilitation, neurosurgery, neurology and clinic anesthesiology and reanimation.

eISSN: 2980-0560
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Original Article
The relationship between isokinetic muscle strength ratios and clinical measures of shoulder stabilization and segmental power: a preliminary study
Abstract
Aims: This study aimed to investigate the relationships between various isokinetic strength ratios-including conventional concentric (CVRC) with separate velocities, conventional eccentric (CVRE), functional deceleration ratio (FDR), and mixed ratios (MR, MR_cross)-and two clinical performance measures; closed kinetic chain upper extremity stability test (CKCUEST) and Unilateral Seated Shot Put Test (USSPT).
Methods: Thirty-two asymptomatic young adults (18-40 years) were assessed using an isokinetic dynamometer (Cybex NORM®, Humac, CA, USA). Seven isokinetic ratios were calculated from peak torque values. CKCUEST and USSPT were used to measure upper extremity stabilization and power, respectively. Normality was tested via Shapiro-Wilk and histogram analysis. Pearson correlation was applied for CKCUEST, and Spearman correlation for USSPT.
Results: No isokinetic ratio was significantly correlated with CKCUEST. For USSPT, CVRC_240 showed the strongest negative correlation (p=-0.585, p<0.001), followed by MR_cross (p=0.467, p=0.007), CVRC_120 (p=-0.422, p=0.016), and CVRC_60 (p=-0.378, p=0.033).
Conclusion: CVRC_240 and MR cross ratios demonstrated moderate associations with segmental upper extremity power. These findings support their use as performance markers for ballistic functional tasks, while their lack of correlation with stabilization tests suggests different neuromechanical determinants.

Keywords : Muscle strength, shoulder joint, athletic performance, athletic trainers, athletic injuries

Download Article


1. Ager AL, Borms D, Bernaert M, et al. Can a conservative rehabilitation strategy improve shoulder proprioception? A systematic review. J Sport Rehabil. 2020;30(1):136-151. doi:10.1123/jsr.2019-0400
2. Noffal GJ. Isokinetic eccentric-to-concentric strength ratios of the shoulder rotator muscles in throwers and nonthrowers. Am J Sports Med. 2003;31(4):537-541. doi:10.1177/03635465030310041001
3. Tooth C, Gofflot A, Schwartz C, et al. Risk factors of overuse shoulder injuries in overhead athletes: a systematic review. Sports Health. 2020; 12(5):478-487. doi:10.1177/1941738120931764
4. Berckmans K, Maenhout AG, Matthijs L, Pieters L, Castelein B, Cools AM. The isokinetic rotator cuff strength ratios in overhead athletes: assessment and exercise effect. Phys Ther Sport. 2017;27:65-75. doi:10.1016/j.ptsp.2017.03.001
5. Yildiz Y, Aydin T, Sekir U, Kiralp MZ, Hazneci B, Kalyon TA. Shoulder terminal range eccentric antagonist/concentric agonist strength ratios in overhead athletes. Scand J Med Sci Sports. 2006;16(3):174-180. doi:10. 1111/j.1600-0838.2005.00471.x
6. Wilkinson MS, Guy JH, Obst SJ. Isokinetic shoulder strength and its associations to ınjury in tactical populations: a critical review. Int J Exerc Sci. 2024;17(3):235-251. doi:10.70252/TDKV8862
7. Barbosa GM, Calixtre LB, Fonseca Fialho HR, Locks F, Kamonseki DH. Measurement properties of upper extremity physical performance tests in athletes: a systematic review. Braz J Phys Ther. 2024;28(1):100575. doi: 10.1016/j.bjpt.2023.100575
8. Leahy I, Florkiewicz E, Shotwell MP. Isokinetic dynamometry for external and internal rotation shoulder strength in youth athletes: a scoping review. Int J Sports Phys Ther. 2024;19(12):1521-1531. doi:10. 26603/001c.125765
9. Declève P. Analytical and Functional Assessment of the Athlete’s Shoulder Ghent University; 2021. Accessed 27.07.2025. https://www.epauleautop.com/wp-content/uploads/2020/10/24082021_These-P.-Decleve.pdf
10. Secchi LLB, Kamonseki DH, Camargo PR, Mendonça LM. Is the isometric strength of the shoulder associated with functional performance tests in overhead athletes?. Phys Ther Sport. 2022;55:131-138. doi:10.1016/j.ptsp.2022.03.007
11. Waldhelm A, Aida J, Boyd J, et al. Relationship between shoulder rotation strength and upper extremity functional assessments in collegiate baseball players. J Funct Morphol Kinesiol. 2025;10(2):120. doi:10.3390/jfmk10020120
12. Lobo JD, Motimath B, Chivate D. Correlation between shoulder external-internal rotation strength ratio and throwing accuracy in cricketers: an observational study. Age (yrs). 2025;20(2):77.
13. Habets B, Staal JB, Tijssen M, van Cingel R. Intrarater reliability of the Humac NORM isokinetic dynamometer for strength measurements of the knee and shoulder muscles. BMC Res Notes. 2018;11(1):15. doi:10. 1186/s13104-018-3128-9
14. Saccol MF, Gracitelli GC, da Silva RT, et al. Shoulder functional ratio in elite junior tennis players. Phys Ther Sport. 2010;11(1):8-11. doi:10.1016/j.ptsp.2009.11.002
15. Tucci HT, Martins J, Sposito Gde C, Camarini PM, de Oliveira AS. Closed kinetic chain upper extremity stability test (CKCUES test): a reliability study in persons with and without shoulder impingement syndrome. BMC Musculoskelet Disord. 2014;15:1. doi:10.1186/1471-2474-15-1
16. Torabi TP, Bencke J, van den Tillaar R. The closed kinetic chain upper extremity stability test (CKCUEST) performance in elite team handball players playing with shoulder pain, previous pain, or no pain. Int J Sports Phys Ther. 2024;19(2):189-198. doi:10.26603/001c.92014
17. Heick JD, Haggerty J, Manske RC. A Comparison of resting scapular posture and the davies closed kinetic chain upper extremity stability test. Int J Sports Phys Ther. 2021;16(3):835-843. doi:10.26603/001c.23425
18. Linkovski M, Lewis J, Sarig Bahat H. Validity and feasibility of the seated medicine ball throw and unilateral shot-put tests in assessing upper extremity function in rotator-cuff-related shoulder pain. Appl Sci. 2024;14(24):12038. doi:10.3390/app142412038
19. Chmielewski TL, Martin C, Lentz TA, et al. Normalization considerations for using the unilateral seated shot put test in rehabilitation. J Orthop Sports Phys Ther. 2014;44(7):518-524. doi:10. 2519/jospt.2014.5004
20. Hadjisavvas S, Efstathiou MA, Themistocleous IC, et al. Can resistance training improve throwing performance in handball players? A systematic review and meta-analysis. BMC Sports Sci Med Rehabil. 2024;16(1):85. doi:10.1186/s13102-024-00872-y
21. Roach NT, Lieberman DE. Upper body contributions to power generation during rapid, overhand throwing in humans. J Exp Biol. 2014;217(Pt 12):2139-2149. doi:10.1242/jeb.103275
22. Agrebi B, Dhahbi W, Abidi H, et al. Isokinetic peak torque improvement and shoulder muscle ratios ımbalance correction after specific strength training on a new ballistic throwing device: a randomized controlled trial. J Sport Rehabil. 2024;33(6):423-436. doi:10.1123/jsr.2023-0253
23. Forthomme B, Crielaard JM, Forthomme L, Croisier JL. Field performance of javelin throwers: relationship with isokinetic findings. Isokinet Exercis Sci. 2007;15(3):195-202. doi:10.3233/IES-2007-0273
24. Schilling DT, Elazzazi AM. Shoulder strength and closed kinetic chain upper extremity stability test performance in division III collegiate baseball and softball players. Int J Sports Phys Ther. 2021;16(3):844-853. doi:10.26603/001c.24244
25. Decleve P, Van Cant J, De Buck E, Van Doren J, Verkouille J, Cools AM. The self-assessment corner for shoulder strength: reliability, validity, and correlations with upper extremity physical performance tests. J Athl Train. 2020;55(4):350-358. doi:10.4085/1062-6050-471-18
26. Palmer TG. Effects of proximal stability training on sport performance and proximal stability measures. 2012.
27. Arghadeh R, Alizadeh MH, Minoonejad H, Sheikhhoseini R, Asgari M, Jaitner T. Electromyography of scapular stabilizers in people without scapular dyskinesis during push-ups: a systematic review and meta-analysis. Front Physiol. 2023;14:1296279. doi:10.3389/fphys.2023.1296 279
28. Vargas VZ, Motta C, Vancini RL, Barbosa de Lira CA, Andrade MS. Shoulder isokinetic strength balance ratio in overhead athletes: a cross-sectional study. Int J Sports Phys Ther. 2021;16(3):827-834. doi:10. 26603/001c.22162
29. Mayer F, Baur H, Hirschmüller A, Heitkamp H, Horstmann T, Dickhuth H. The quantification of reciprocal shoulder strength relation in various working modes at different movement velocities. Isokinet Exercis Sci. 2001;9(2-3):73-77. doi:10.3233/IES-2001-0068
30. Land H, Gordon S. What is normal isokinetic shoulder strength or strength ratios? A systematic review. Isokinet Exercis Sci. 2011;19(4):231-241. doi:10.3233/IES-2011-0427
31. Mak N, Howe S, Monkman E, Pemberton M, Whiffin E, Samuel D. The relationship between muscle strength, balance and functional ability in recreationally active young adults. Physiotherapy. 2024;123:e78-e79. </ol> <p>
Article available in :
Volume 3, Issue 4, 2025
Page : 90-94
https://doi.org/10.51271/JORR-0058
Article Information
Received : 27 Tem 2025
Accepted : 11 Eki 2025
Published : 22 Eki 2025
Corresponding Author :

Gökhan Mehmet Karatay: Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Tokat Gaziosmanpaşa University, Tokat, Turkiye

[email protected]
Citation : Karatay GM, Güzel NA. The relationship between isokinetic muscle strength ratios and clinical measures of shoulder stabilization and segmental power: a preliminary study. J Orthop Res Rehabil. 2025;3(4):90-94.

Read: 73
Download : 34
Cited: 0
_Footer