Absolute reliability and concurrent validity of hand held dynamometry and isokinetic dynamometry in the hip, knee and ankle joint: systematic review and meta-analysis

AbstractThe purpose of the study is to establish absolute reliability and concurrent validity between hand-held dynamometers (HHDs) and isokinetic dynamometers (IDs) in lower extremity peak torque assessment. Medline, Embase, CINAHL databases were searched for studies related to psychometric properties in muscle dynamometry. Studies considering standard error of measurement SEM (%) or limit of agreement LOA (%) expressed as percentage of the mean, were considered to establish absolute reliability while studies using intra-class correlation coefficient (ICC) were considered to establish concurrent validity between dynamometers. In total, 17 studies were included in the meta-analysis. The COSMIN checklist classified them between fair and poor. Using HHDs, knee extension LOA (%) was 33.59%, 95% confidence interval (CI) 23.91 to 43.26 and ankle plantar flexion LOA (%) was 48.87%, CI 35.19 to 62.56. Using IDs, hip adduction and extension; knee flexion and extension; and ankle dorsiflexion showed LOA (%) under 15%. Lower hip, knee, and ankle LOA (%) were obtained using an ID compared to HHD. ICC between devices ranged between 0.62, CI (0.37 to 0.87) for ankle dorsiflexion to 0.94, IC (0.91to 0.98) for hip adduction. Very high correlation were found for hip adductors and hip flexors and moderate correlations for knee flexors/extensors and ankle plantar/dorsiflexors.

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Absolute Reliability and Concurrent Validity of Hand-Held Dynamometry in Shoulder Rotator Strength Assessment: Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18179293 ◽

2021 ◽

Vol 18 (17) ◽

pp. 9293

Author(s):

Claudio Chamorro ◽

Miguel Arancibia ◽

Benjamín Trigo ◽

Leónidas Arias-Poblete ◽

Daniel Jerez-Mayorga

Keyword(s):

Concurrent Validity ◽

Meta Analysis ◽

Minimal Detectable Change ◽

Measurement Instruments ◽

Health Measurement ◽

Strength Assessment ◽

Cosmin Checklist ◽

Standard Error Of Measurement ◽

Intra Class Correlation Coefficient ◽

Absolute Reliability

The purpose of this study is to establish the absolute reliability between hand-held dynamometers (HHDs) and concurrent validity between HHDs and isokinetic dynamometers (IDs) in shoulder rotator strength assessment. The Medline, CINAHL, and Central databases were searched for relevant studies up to July 2020. Absolute reliability was determined by test–retest studies presenting standard error of measurement (SEM%) and/or minimal detectable change (MDC%) expressed as percentage of the mean. Studies considering intra-class correlation coefficient (ICC) between IDs and HHDs were considered for concurrent validity. The risk of bias and the methodological quality were evaluated according to COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Thirteen studies were included in the meta-analysis. Shoulder internal rotator strength assessment MDC% was 0.78%, 95% confidence interval (CI) −5.21 to 3.66, while shoulder external rotators MDC% was 3.29%, CI −2.69 to 9.27. ICC between devices was 0.94, CI (0.91 to 0.96) for shoulder internal rotators and 0.92, IC (0.88 to 0.97) for shoulder external rotators. Very high correlation was found for shoulder rotator torque assessment between HHDs and IDs. The COSMIN checklist classified the selected studies as adequate and inadequate.

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Reliability and Concurrent Validity of the Test of Motor Impairment-Henderson Revision

Adapted Physical Activity Quarterly ◽

10.1123/apaq.7.3.249 ◽

1990 ◽

Vol 7 (3) ◽

pp. 249-258 ◽

Cited By ~ 16

Author(s):

Katherine J. Riggen ◽

Dale A. Ulrich ◽

John C. Ozmun

Keyword(s):

Standard Error ◽

Concurrent Validity ◽

Test Score ◽

Short Form ◽

Motor Impairment ◽

Final Test ◽

Motor Proficiency ◽

Standard Error Of Measurement ◽

Absolute Reliability ◽

Error Of Measurement

The reliability and concurrent validity of the Test of Motor Impairment-Henderson Revision was evaluated employing a sample of preschoolers. Absolute reliability of the final test score was established by calculating the standard error of measurement (SEM). An SEM of .86 was obtained. The consistency of decisions related to motor impairment or nonimpairment was estimated by calculating the proportion of agreement index across two testing occasions and Kappa. A 90% agreement was obtained with Kappa equal to .71. Concurrent validity using the Bruininks-Oseretsky Test of Motor Proficiency-Short Form as the criterion resulted in an 88% agreement between the two tests.

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Discriminatory Ability of Lower-Extremity Peak Torque and Rate of Torque Development in the Identification of Older Women With Slow Gait Speed

Journal of Applied Biomechanics ◽

10.1123/jab.2016-0354 ◽

2018 ◽

Vol 34 (4) ◽

pp. 270-277 ◽

Cited By ~ 1

Author(s):

Mary Hellen Morcelli ◽

Dain Patrick LaRoche ◽

Luciano Fernandes Crozara ◽

Nise Ribeiro Marques ◽

Camilla Zamfolini Hallal ◽

...

Keyword(s):

Older Women ◽

Gait Speed ◽

Plantar Flexion ◽

Peak Torque ◽

Knee Extension ◽

Muscle Group ◽

Rate Of Torque Development ◽

Functional Gait ◽

Hip Extension ◽

Torque Development

The aim was to compare torque and rate of torque development of lower limb muscles between older women with functional and slow gait speeds to determine which muscle group is the best predictor of functional gait speed, and to establish strength thresholds needed for functional walking speed. Torque and rate of torque development of hip, knee, and ankle muscles were measured in older women who were divided in 2 groups according to gait speed: slow gait speed (<1.22 m·s−1) and functional gait speed (≥1.22 m·s−1). For each muscle group, 3 maximal isometric contractions were performed, and peak torque and rate of torque development were recorded. Older women with slow gait speed had lower peak torque than older women with functional gait speed for hip extension (28%), knee flexion (15%), knee extension (14%), and plantar flexion (16%) (allPs < .05). Older women with slow gait speed had lower peak rate of torque development for hip flexion (29%), hip extension (37%), knee flexion (34%), knee extension (33%), and plantar flexion (19%) (allPs < .05). Knee extension peak rate of torque development and hip extension peak torque were the better predictors of functional gait speed with thresholds of 2.96 N·m·s−1·kg−1and 1.26 N·m·kg−1, respectively.

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Altered Strength Profile in Achilles Tendinopathy: A Systematic Review and Meta-Analysis

Journal of Athletic Training ◽

10.4085/1062-6050-43-18 ◽

2019 ◽

Vol 54 (8) ◽

pp. 889-900 ◽

Cited By ~ 3

Author(s):

Seán McAuliffe ◽

Ariane Tabuena ◽

Karen McCreesh ◽

Mary O'Keeffe ◽

John Hurley ◽

...

Keyword(s):

Data Extraction ◽

Meta Analysis ◽

Plantar Flexion ◽

Reaction Force ◽

Peak Torque ◽

Achilles Tendinopathy ◽

Rehabilitation Outcomes ◽

Explosive Strength ◽

Increased Risk ◽

Meta Analyses

Background Persistent strength deficits secondary to Achilles tendinopathy (AT) have been postulated to account for difficulty engaging in tendon-loading movements, such as running and jumping, and may contribute to the increased risk of recurrence. To date, little consensus exists on the presence of strength deficits in AT. Consequently, researchers are uncertain about the appropriate methods of assessment that may inform rehabilitation in clinical practice. Objective To evaluate and synthesize the literature investigating plantar-flexion (PF) strength in individuals with AT. Study Selection Two independent reviewers searched 9 electronic databases using an agreed-upon set of key words. Data Extraction Data were extracted from studies comparing strength measures (maximal, reactive, and explosive strength) between individuals with AT and healthy control participants or between the injured and uninjured sides of people with AT. The Critical Appraisal Skills Programme Case-Control Study Checklist was used to assess the risk of bias for the included studies. Data Synthesis A total of 19 studies were eligible. Pooled meta-analyses for isokinetic dynamometry demonstrated reductions in maximal strength (concentric PF peak torque [PT] slow [Hedges g = 0.52, 44% deficit], concentric PF PT fast [Hedges g = 0.61, 38% deficit], and eccentric PF PT slow [Hedges g = 0.26, 18% deficit]). Reactive strength, particularly during hopping, was also reduced (Hedges g range = 0.32–2.61, 16%–35% deficit). For explosive strength, reductions in the rate of force development (Hedges g range = 0.31–1.73, 10%–21% deficit) were observed, whereas the findings for ground reaction force varied but were not consistently altered. Conclusions Individuals with AT demonstrated strength deficits compared with the uninjured side or with asymptomatic control participants. Deficits were reported across the strength spectrum for maximal, reactive, and explosive strength. Clinicians and researchers may need to adapt their assessment of Achilles tendon function, which may ultimately help to optimize rehabilitation outcomes.

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Unilateral Knee and Ankle Joint Fatigue Induce Similar Impairment to Bipedal Balance in Judo Athletes

Journal of Human Kinetics ◽

10.2478/hukin-2018-0063 ◽

2019 ◽

Vol 66 (1) ◽

pp. 7-18 ◽

Cited By ~ 1

Author(s):

Amine Ghram ◽

James D Young ◽

Rahman Soori ◽

David G Behm

Keyword(s):

Postural Control ◽

Plantar Flexion ◽

National Level ◽

Peak Torque ◽

Knee Extension ◽

Plantar Flexors ◽

Training Experience ◽

Eyes Closed ◽

Eyes Open ◽

Judo Athletes

Abstract The purpose of this study was to compare the effects of unilateral ankle fatigue versus the knee muscles with and without vision on bipedal postural control. Elite judo athletes who competed at the national level with at least 10 years of training experience, were randomised into KNEE (n = 10; 20 ± 2 years) and ANKLE (n = 9; 20 ± 3 years) groups, who performed dynamic isokinetic fatiguing contractions (force decreased to 50% of initial peak torque for three consecutive movements) of the knee flexors and extensors or ankle dorsiflexors and plantar flexors, respectively. Static bipedal postural control (French Posturology Association normative standards) with eyes open and eyes closed was examined before and immediately after the fatiguing task. Postural variables examined were the centre of pressure (CoP) sway in the medio-lateral and antero-posterior directions, total CoP area sway and CoP sway velocity. Although unilateral ankle and knee fatigue adversely affected all bipedal postural measures, with greater disturbances with eyes closed, there were no significant main group or interaction effects between KNEE and ANKLE groups. Unilateral lower limb fatigue adversely affected bipedal balance, with knee extension/flexion fatigue affecting bipedal postural control to a similar extent as unilateral ankle dorsiflexion/plantar flexion fatigue. Hence unilateral fatigue can affect subsequent bilateral performance or also have implications for rehabilitation exercise techniques. Our findings may be limited to judo athletes as other populations were not tested.

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Reliability of Ankle Isometric, Isotonic, and Isokinetic Strength and Power Testing in Older Women

Physical Therapy ◽

10.2522/ptj.20090394 ◽

2010 ◽

Vol 90 (8) ◽

pp. 1165-1175 ◽

Cited By ~ 65

Author(s):

Sandra C. Webber ◽

Michelle M. Porter

Keyword(s):

Older Women ◽

Peak Power ◽

Peak Velocity ◽

Plantar Flexion ◽

Intraclass Correlation ◽

Peak Torque ◽

Minimal Detectable Change ◽

Homogeneous Sample ◽

Ankle Strength ◽

Absolute Reliability

BackgroundAnkle strength (force-generating capacity) and power (work produced per unit of time or product of strength and speed) capabilities influence physical function (eg, walking, balance) in older adults. Although strength and power parameters frequently are measured with dynamometers, few studies have examined the reliability of measurements of different types of contractions.ObjectiveThe purpose of this study was to examine relative and absolute intrarater reliability of isometric, isotonic, and isokinetic ankle measures in older women.DesignThis was a prospective, descriptive methodological study.MethodsThe following dorsiflexion (DF) and plantar-flexion (PF) measures were assessed twice (7 days apart) by the same examiner in 30 older women (mean age=73.3 years, SD=4.7): isometric peak torque and rate of torque development (RTD), isotonic peak velocity, average acceleration and peak power, and isokinetic peak torque and peak power (30°/s and 90°/s). Several statistical methods were used to examine relative and absolute reliability.ResultsIntraclass correlation coefficients (ICCs) for the DF tests (ICC=.76–.97) were generally higher than ICCs for matched PF tests (ICC=.58–.93). Measures of absolute reliability (eg, coefficient of variation of the typical error [CVTE]) also demonstrated more reliable values for DF tests (5%–18%) compared with PF tests (7%–37%). Isotonic peak velocity tests at minimal loads were associated with the lowest CVTE and ratio limits of agreement values for both DF (5% and 14%, respectively) and PF (7% and 18%, respectively). Isometric RTD variables were the least reliable (CVTE=16%–37%).LimitationsThis study was limited to a relatively homogeneous sample of older women.ConclusionsTest-retest reliability was adequate for determining changes at the group level for all strength and power variables except isometric RTD. Minimal detectable change scores were determined to assist clinicians in assessing meaningful change over time in ankle strength and power measurements within individuals.

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602 THE EFFECT OF BILATERAL ISOKINETIC KNEE EXTENSION/FLEXION ON JOINT ANGLE AT PEAK TORQUE

Medicine & Science in Sports & Exercise ◽

10.1249/00005768-199305001-00604 ◽

1993 ◽

Vol 25 (Supplement) ◽

pp. S108 ◽

Cited By ~ 1

Author(s):

J. R. Bryant ◽

L. E. Brown ◽

M. Whitehurst

Keyword(s):

Joint Angle ◽

Peak Torque ◽

Knee Extension

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Correlation of paretic knee extension strength with gait speed after stroke: A meta-analysis

Isokinetics and Exercise Science ◽

10.3233/ies-210139 ◽

2021 ◽

pp. 1-5

Author(s):

Richard W. Bohannon

Keyword(s):

Gait Speed ◽

Meta Analysis ◽

Relevant Literature ◽

Knee Extension ◽

Bibliographic Databases ◽

Knee Extension Strength ◽

Extension Force ◽

Correlational Data ◽

Using Data ◽

The Relationship

BACKGROUND AND OBJECTIVE: Numerous studies have addressed the relationship between paretic knee extension strength and comfortable walking speed after stroke. However, the correlations reported are highly variable. This review sought to summarize the correlational data using meta-analysis. METHODS: Relevant literature was identified via a search of 3 bibliographic databases. Articles were screened and perused for inclusion. Included articles were examined for information on the sample studied, procedures for measuring strength and gait speed, and correlations reported between the 2 variables. Meta-analysis was used to calculate a summary correlation. RESULTS: Of 299 unique articles, 18 met inclusion criteria. Articles were diverse in regard to samples studied, procedures described, and correlations reported. Meta-analysis using data from all included studies revealed a summary correlation of 0.51. For studies using hand-held or isokinetic dynamometry, the summary correlation was 0.46 and 0.59 respectively. CONCLUSIONS: This study provides a better indication of the correlation between paretic knee extension strength and comfortable gait speed than individual studies. The correlation is high enough to provide support for the routine measurement of paretic knee extension force for individuals who have experienced a stroke.

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Reliability of scapular upward rotation and anterior-posterior tilt measurements using a modified digital inclinometer in patients with subacromial impingement syndrome

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-200080 ◽

2021 ◽

pp. 1-7

Author(s):

Da-In An ◽

Jung-Eun Park ◽

Chang-Hyung Lee ◽

Soo-Yong Kim

Keyword(s):

Intraclass Correlation ◽

Absolute Measurement ◽

Impingement Syndrome ◽

Subacromial Impingement Syndrome ◽

Subacromial Impingement ◽

Digital Inclinometer ◽

Posterior Tilt ◽

Standard Error Of Measurement ◽

Absolute Reliability ◽

Anterior Posterior

BACKGROUD: Reliable scapular upward rotation and anterior-posterior tilt data are required for patients with subacromial impingement syndrome (SIS). Only a few studies have explored the reliability of such measurements derived using a modified inclinometer. OBJECTIVES: To determine the relative and absolute reliability of scapular upward rotation and anterior-posterior tilt measurements derived using a modified digital inclinometer in patients with SIS. METHOD: Seventeen SIS patients were assessed twice within 1 week. We determined the relative and absolute measurement reliability by calculating the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal clinically important difference (MCID). Both intra- and interrater reliability were determined. RESULTS: The intra-rater reliability (both measurements) was high (0.72–0.88), and the interrater ICC was high to excellent (0.72–0.98). Clinically acceptable SEM and MCID values were obtained for scapular upward rotation (SEM: 4.28–9.33∘, MCID: 5.1–11.3∘) and anterior-posterior tilt (SEM: 3.72–7.55∘, MCID: 2.5–10.8∘). CONCLUSIONS: Measurements of scapular upward rotation and anterior-posterior tilt using a modified digital inclinometer reliably reveal scapular position and kinematics in patients with SIS.

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Reliability of a New Portable Dynamometer for Assessing Hip and Lower Limb Strength

Applied Sciences ◽

10.3390/app11083391 ◽

2021 ◽

Vol 11 (8) ◽

pp. 3391

Author(s):

Jan Marušič ◽

Goran Marković ◽

Nejc Šarabon

Keyword(s):

Lower Limb ◽

External Rotation ◽

Peak Torque ◽

Knee Extension ◽

Lower Limb Muscles ◽

Lower Limb Strength ◽

Flexion Extension ◽

Strength Tests ◽

Hip Abduction ◽

Maximal Peak

The purpose of this study was to evaluate intra- and inter-session reliability of the new, portable, and externally fixated dynamometer called MuscleBoard® for assessing the strength of hip and lower limb muscles. Hip abduction, adduction, flexion, extension, internal and external rotation, knee extension, ankle plantarflexion, and Nordic hamstring exercise strength were measured in three sessions (three sets of three repetitions for each test) on 24 healthy and recreationally active participants. Average and maximal value of normalized peak torque (Nm/kg) from three repetitions in each set and agonist:antagonist ratios (%) were statistically analyzed; the coefficient of variation and intra-class correlation coefficient (ICC2,k) were calculated to assess absolute and relative reliability, respectively. Overall, the results display high to excellent intra- and inter-session reliability with low to acceptable within-individual variation for average and maximal peak torques in all bilateral strength tests, while the reliability of unilateral strength tests was moderate to good. Our findings indicate that using the MuscleBoard® dynamometer can be a reliable device for assessing and monitoring bilateral and certain unilateral hip and lower limb muscle strength, while some unilateral strength tests require some refinement and more extensive familiarization.

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