Assessing Shoulder Proprioceptive Sense of Force: Hand-Held Dynamometer Reliability and Comparison with Isokinetic Protocols.
Xavier Amen, Jean-Sébastien Roy, Stéphane Baudry and 2 others
PMID 40041531WHAT IT FOUND
A hand-held dynamometer protocol for shoulder force sense showed only low-to-moderate reliability and did not agree with isokinetic results.
Clinicians should not use it for diagnosis. If used, test at 50% maximum strength, as lower intensities were less accurate.
Key findings
01The hand-held dynamometer protocol showed low to moderate intra-rater reliability and little to low inter-rater reliability, meaning scores varied significantly between days and between different examiners.
02Measurements from the hand-held dynamometer did not agree with the isokinetic dynamometer at higher force levels, so results from the two devices cannot be compared directly.
03Force reproduction error was significantly higher at 10% of maximum strength than at 30% or 50%, suggesting low-intensity testing is less accurate for assessing sense of force.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study included only healthy young adults (18-35 years) with no shoulder pain, so results cannot be generalized to patients with shoulder instability, pain, or other pathologies. The hand-held dynamometer was held by the examiner without external fixation, which likely contributed to the poor inter-rater reliability and variability compared to the stable isokinetic dynamometer. The full protocol took nearly two hours, which may have introduced fatigue or motivation issues in participants, although the authors note a clinical version would take less than ten minutes. Inter-rater reliability was very low (ICC 0.07-0.43), meaning different clinicians are likely to get significantly different scores from the same patient.
Declared interests
The authors report no conflicts of interest.
The easy way to misread this
Do not interpret changes in a patient's hand-held dynamometer force-sense scores as clinical progress or regression. The study found low to moderate reliability and very poor inter-rater reliability, meaning score variations are likely due to measurement error or examiner differences rather than actual changes in the patient's proprioception.