Isometric shoulder torque in subjects with spinal cord injury

The etiology of shoulder pain in spinal cord injured (SCI) patients has been attributed to overuse, with dysfunction being more prevalent as the time since injury increases. Impingement syndrome, the most common diagnosis in this population, may be related to weakness of the rotator cuff and shoulder girdle musculature. Shoulder dysfunction is greater in subjects with SCI than in able-bodied patients; consequently, this study compares isometric strength of quadriplegic and paraplegic subjects to able-bodied controls. Peak isometric torque for internal rotation, external rotation, and scapular elevation was assessed using a Lido isokinetic dynamometer. The strength (torque) values of the quadriplegic group were significantly lower than the control group and paraplegic group for all motions tested (p < .0005). The only significant difference between the paraplegic and able-bodied groups was found with internal rotation (p < .0001). These results indicate that quadriplegic patients may be at greater risk for shoulder pathology because of both muscular limitation and increased functional demand.