Assessment of Shoulder Peak Torque and Fatigue Index in Individuals With Adhesive Capsulitis (AC)

Biomechanical Assessment of Shoulder Peak Torque and Fatigue Index in Individuals With Adhesive Capsulitis: A Case-Control Study

Adhesive capsulitis (AC) is a common painful disorder associated with diminishing glenohumeral movement. This has led to the need for an evidence-based approach to assess the isokinetic strength and endurance of shoulder muscles in such disease conditions.The main aim of the current study was to determine whether isokinetic dynamometric values of peak torque (PT) and fatigue index of shoulder muscles are different between patients with AC in the recovery phase and the healthy subjects.

Study Overview

• Status: Completed
• Conditions: Adhesive Capsulitis
• Intervention / Treatment: Diagnostic test: shoulder abductor, internal rotator and external rotator Isokinetic peak torques and fatigue indices

Detailed Description

Adhesive capsulitis (AC) is a common painful disorder associated with diminishing glenohumeral movement. This has led to the need for an evidence-based approach to assess the isokinetic strength and endurance of shoulder muscles in such disease conditions.The main aim of the current study was to determine whether isokinetic dynamometric values of peak torque (PT) and fatigue index of shoulder muscles are different between patients with AC in the recovery phase and the healthy subjects.The study involved a total of sixty subjects within the age group 40 and 60 years comprising thirty in the recovery phase of AC and thirty healthy controls. The Biodex System 3 Isokinetic dynamometer was used to measure shoulder abductor, internal rotator and external rotator peak torques and fatigue indices.

• Study Type: Observational
• Enrollment (Actual): 60

Contacts and Locations

Study Locations

• Egypt
  • Giza Governorate
    • Giza, Giza Governorate, Egypt, 12511
      • Faculty of physical therapy, Cairo University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

In the present study, 60 participants between 40 and 60 years were recruited. They were enrolled in the experimental group, which included 30 typical subjects with unilateral AC and the control group (dominant shoulder) that included 30 healthy individuals of the same age and sex. Individuals were recruited from the outpatient clinics and respective orthopedic centers. They were informed through an advertisement poster placed on the bulletin of the mentioned locations and referred from a physician.

Description

Inclusion Criteria:

The AC group included participants that met the following criteria, based on a previous study conducted by Ramirez [2] :

1. clinical diagnosis of unilateral AC by an orthopedic specialist, with the limitation of both active and passive glenohumeral ROM, exceeding 25% in at least two of the following planes: flexion, abduction, and external rotation
2. symptom duration between 3 and 12 months
3. no prior surgery to the involved shoulder
4. age between 40 and 60 years. -The control group consisted of healthy individuals of comparable age and sex distribution with no history of shoulder pain, injury, or pathology

Exclusion Criteria:

1. history of shoulder fracture, dislocation, or surgery;
2. corticosteroid or muscle relaxant use within the previous three months
3. cardiovascular or respiratory conditions that could limit physical testing
4. concurrent participation in structured shoulder strengthening programs
5. inability to perform the isokinetic assessment protocol safely
6. systemic musculoskeletal, neurological or rheumatologic disorders, such as diabetes mellitus, rheumatoid arthritis and cervical radiculopathy. Individuals with diabetes mellitus were excluded due to its well-established association with AC.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
healthy control group; 30 healthy controls participated in the study	Diagnostic test: shoulder abductor, internal rotator and external rotator Isokinetic peak torques and fatigue indices; The Biodex System 3 Isokinetic dynamometer was used to measure shoulder abductor, internal rotator and external rotator peak torques and fatigue indices
group of Adhesive capsulitis (AC); 30 patients with AC participated in the study	Diagnostic test: shoulder abductor, internal rotator and external rotator Isokinetic peak torques and fatigue indices; The Biodex System 3 Isokinetic dynamometer was used to measure shoulder abductor, internal rotator and external rotator peak torques and fatigue indices

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
shoulder abductor peak torque	shoulder abductor isokinetic peak torque	one year
shoulder internal rotator peak torque	shoulder internal rotator isokinetic peak torque	one year
shoulder external rotator peak torque	shoulder external rotator isokinetic peak torque	one year
shoulder abductor fatigue index	shoulder abductor isokinetic fatigue index	one year
shoulder internal rotator fatigue index	shoulder internal rotator isokinetic fatigue index	one year
shoulder external rotator fatigue index	shoulder external rotator isokinetic fatigue index	one year

Collaborators and Investigators

• Sponsor: Cairo University
• Investigators: Principal Investigator: Azza M, professor, Cairo university

Publications and helpful links

Helpful Links

• Isokinetic characteristics of shoulder rotators in patients with adhesive capsulitis

Study record dates

Study Major Dates

• Study Start (Actual): February 20, 2015
• Primary Completion (Actual): November 10, 2016
• Study Completion (Actual): December 3, 2016

Study Registration Dates

• First Submitted: March 27, 2026
• First Submitted That Met QC Criteria: April 2, 2026
• First Posted (Actual): April 9, 2026

Study Record Updates

• Last Update Posted (Actual): April 9, 2026
• Last Update Submitted That Met QC Criteria: April 2, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Adhesive Capsulitis; frozen shoulder; peak torque; fatigue index; isokinetic dynamometry
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Joint Diseases; Bursitis
• Other Study ID Numbers: P.T.REC/012/006256

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No