Hand‐held dynamometry for muscle strength measurement in children with cerebral palsy

Abstract

The aim of this study was to investigate the reliability of hand‐held dynamometry for measuring isometric lower‐limb muscle strength in children with cerebral palsy (CP). Twentythree children (14 males, nine females) with CP (spastic diplegia; Gross Motor Function Classification System Levels I‐III) aged 5 years 7 months to 14 years 5 months (mean 9y 6mo [SD 2y 8mo]) attended two test sessions 1 week apart. A ‘make’ test, using a gradual build‐up of force to a maximum isometric contraction, was employed and peak values were normalized to body weight for analyses. Within‐session reliability was high with an intraclass correlation coefficient (ICC) of 1,1>0.79 for all muscle groups, and there was acceptable between‐session reliability ICC>0.70 and measurement errors for hip flexors and extensors (measured in supine), knee flexors and extensors, and ankle dorsiflexors (with stabilization). Within‐ and between‐session reliability was poor (ICC<0.70) for hip extensors (in prone), knee extensors (20° flexion), ankle dorsiflexors (without stabilization), and ankle plantarflexors. Measurement error differed in each test and across limbs, with stabilization producing inconsistent reliability outcomes. Changes in strength measurements in children with CP should take into account measurement error for particular muscle groups. Changes should be determined for separate muscle groups and limbs, and reported relative to body weight. Different testing positions may be required for greater reliability.

Muscle strength and walking ability in Diplegic Cerebral Palsy: Implications for assessment and management

“…Crompton et al [20] have shown it is possible to measure this muscle group reliably in supine lying but not in prone. We deliberately chose supine lying with the hip and knee flexed as a gravity-neutral position, and to isolate gluteus maximus from the hamstrings.…”

Temporomandibular disorders in cerebral palsy: literature review

“…These clinical signs show that morphological changes and changes in the craniometric structure, caused by TMD in the joint components of patients with CP are important functional restriction factors, similarly seen in other pathologies and joint degenerative diseases (FLETT, 2003;CROMPTON, GALEA and PHILLIPS, 2007).…”

“…According to the severity of motor damage, patients may later show signs of tetraplegia, diplegia, our hemiplegia, involving, respectively, four members, limited to lower limbs and/or a hemibody (FLETT, 2003;DAMIANO, ABEL, ROMNESS et al, 2006;ROMEO, CIONI, SCOTO et al, 2008;CROMPTON, GALEA and PHILLIPS, 2007). The existent tonic changes may lead, due to encephalopathy, to spasticity, athetosis, dystonic coreoathetosis, or ataxia, with variation according to which areas and regions of the CNS have been harmed (PALISANO, ROSENBAUM, WALTER et al, 1997;DAMIANO, DODD andTAYLOR, 2002, DAMIANO, ABEL, ROMNESS et al, 2006;SCHOEN, RICCI, and OLIVEIRA, 2003).…”

Hip Extension Range of Motion in Lightening Position and Active Placing of the Hip Joint in Functional Position Among Young Women With and Without Low Back Pain

“…Wy prost w sta wie biodro wym oce nia ny jest w po zy cji le że nia przo dem, z wy pro sto wa nym sta wem ko la no wym w koń czy nie ba da nej. Wia ry god ność po mia rów w tej po zy cji jest ni ska [14][15][16], a punk ty pod par cia mied ni cy za le żą od bu do wy fi zycz nej oso by ba da nej. Do oce ny dłu go ści zgi na czy sta wu bio dro we go, a tym sa mym do oce ny wy pro stu w sta wie bio dro wym, wy ko rzy sty wa ne są rów nież na stę pu ją ce te sty: Tho ma sa [17], zmo dy fi kowa ny test Tho ma sa [17] oraz test Jan dy [18].…”

“…Extension of the hip is assessed in the prone position with the knee joint flexed on the examined side. Reliability of the measurements in this position is low [14][15][16] and the pelvic support points depend on the physical build. To evaluate the length of the hip flexors, and therefore to evaluate the extension in the hip joint, following tests are also used: Thomas's test [17], Thomas's modified test [17] and Janda's test [18].…”