Repeatability, consistency, and accuracy of hand‐held dynamometry with and without fixation for measuring ankle plantarflexion strength in healthy adolescents and adults

Davis, Paula K.; McKay, Marnee J.; Baldwin, Jennifer; Burns, Joshua; Pareyson, Davide; Rose, Kristy

doi:10.1002/mus.25576

Cited by 21 publications

(18 citation statements)

References 24 publications

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“…The comparison between fixed and non-fixed methods demonstrated the superiority of the non-fixed method regarding both intra-examiner and inter-examiner assessments. This finding is similar to that found by Davis et al 15 in a study that assessed Hand-Held dynamometry reliability for plantar flexion. Regarding the fact that higher ICC were found for the non-fixed method, in comparison with the fixed method, it is worth mentioning that both methods showed excellent reliability.…”

Section: Anterior Carpal Surfacesupporting

confidence: 91%

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Comparison of Methods for Evaluating Upper Limb Strength by Hand-Held Dynamometry

Júnior

Menezes

Santos

et al. 2021

Rev Bras Med Esporte

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Introduction The upper limbs are segments of the human body responsible for primary activities of daily life, and the muscles are essential structures for performing these activities. There have been few studies on intra- and inter-examiner reliability of the hand-held dynamometer (HHD) in healthy subjects, and none have been published that compare dynamometric evaluation methods in the main muscles in this segment. Objective Evaluate intra-examiner and inter-examiner assessment reliability of the hand-held dynamometry of upper limb muscles in healthy individuals, as well as comparing the assessment reliability between fixed and non-fixed methods. Methods Healthy subjects aged over 18 years were recruited for the study. The isometric contraction for ten muscle groups of the dominant upper limb was tested. For the fixed method, we used a system of suction cups, connected to the HHD by an inelastic belt. For the non-fixed method, the examiner supported the device by hand. The isometric contraction was sustained for three seconds. Each measurement was repeated three times, considering the highest value obtained. The reliability was calculated using the intraclass correlation coefficient (ICC). The dispersion between measurements was expressed by a Bland-Altman plot. Results The sample consisted of 25 volunteers, all right-handed. The intra-examiner ICC was 0.89-0.99 for the non-fixed method, and 0.43 to 0.85 for the fixed method. Inter-examiner reliability showed equivalent behavior. This study showed that evaluation of upper limb muscle strength using an isometric dynamometer has excellent intra-examiner and inter-examiner reliability. The supine position was chosen due to the need to propose a feasible protocol for clinical practice that could be replicated for the majority of publics and in different environments. The non-fixed method showed better reliability overall, demonstrating the feasibility of this tool without the need for adaptations, additional devices, or increased operating costs for this evaluation. Conclusion Comparison between the fixed and non-fixed HHD methods demonstrated superiority of the non-fixed method in terms of reliability. Level of evidence II; Investigation of a diagnostic exam - Development of diagnostic criteria with consecutive patients.

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Section: Anterior Carpal Surfacesupporting

confidence: 91%

“…14 All patients had the proximal segment (trunk, arm or forearm) stabilized by using a inelastic belt in order to null the effect of synergistic muscle chains and their irradiation of strength. 15…”

Section: Instrumentsmentioning

confidence: 99%

Comparison of Methods for Evaluating Upper Limb Strength by Hand-Held Dynamometry

Júnior

Menezes

Santos

et al. 2021

Rev Bras Med Esporte

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“…32 This method is called the ''do method'' and has provided accurate measurements of isometric muscle strength. 33 This same methodology was used by other authors to evaluate reliability in children with cerebral palsy, aged 7---13 years, in athletes and in young adults. 3,4,34,35 These authors used stabilization belts to help with positioning.…”

Section: Discussionmentioning

confidence: 99%

Isometric muscle strength in children and adolescents using Handheld dynamometry: reliability and normative data for the Brazilian population

Daloia

Leonardi-Figueiredo

Martinez

et al. 2018

Brazilian Journal of Physical Therapy

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“…The following seven muscle groups were assessed: hip adductors, hip abductors, hip extensors, hip flexors, knee extensors, knee flexors, and ankle dorsiflexors. Ankle plantar flexors were not included in the study because of the documented difficulties for reliable measurement with the handheld dynamometer (15,16). All subjects performed three consecutive muscle force measurements with a resting interval of at least 20 s among trials for each muscle group (17,18).…”

Section: Methodsmentioning

confidence: 99%

Development of Lower Extremity Strength in Ambulatory Children With Bilateral Spastic Cerebral Palsy in Comparison With Typically Developing Controls Using Absolute and Normalized to Body Weight Force Values

et al. 2021

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This cross-sectional study aimed to examine the development of lower limb voluntary strength in 160 ambulatory patients with bilateral spastic cerebral palsy (CP) (106 diplegics/54 quadriplegics) and 86 typically developing (TD) controls, aged 7–16 years. Handheld dynamometry was used to measure isometric strength of seven muscle groups (hip adductors and abductors, hip extensors and flexors, knee extensors and flexors, and ankle dorsiflexors); absolute force (AF) values in pounds were collected, which were then normalized to body weight (NF). AF values increased with increasing age (p < 0.001 for all muscle groups), whereas NF values decreased through adolescence (p < 0.001 for all muscle groups except for hip abduction where p = 0.022), indicating that increases in weight through adolescence led to decreases in relative force. Both AF and NF values were significantly greater in TD subjects when compared with children with CP in all muscle and all age groups (p < 0.001). Diplegics and quadriplegics demonstrated consistently lower force values than TD subjects for all muscle groups, except for the hip extensors where TD children had similar values with diplegics (p = 0.726) but higher than quadriplegics (p = 0.001). Diplegic patients also exhibited higher values than quadriplegics in all muscles, except for the knee extensors where their difference was only indicative (p = 0.056). The conversion of CP subjects' force values as a percentage of the TD subjects' mean value revealed a pattern of significant muscle strength imbalance between the CP antagonist muscles, documented from the following deficit differences for the CP muscle couples: (hip extensors 13%) / (hip flexors 32%), (adductors 27%) / (abductors 52%), and (knee extensors 37%) / (knee flexors 53%). This pattern was evident in all age groups. Similarly, significant force deficiencies were identified in GMFCS III/IV patients when compared with TD children and GMFCS I/II patients. In this study, we demonstrated that children and adolescents with bilateral CP exhibited lower strength values in lower limb muscles when compared with their TD counterparts. This difference was more prevalent in quadriplegic patients and those with a more severe impairment. An important pattern of muscle strength imbalance between the antagonist muscles of the CP subjects was revealed.

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Repeatability, consistency, and accuracy of hand‐held dynamometry with and without fixation for measuring ankle plantarflexion strength in healthy adolescents and adults

Abstract: Both methods of measuring ankle plantarflexion force were reliable. Force measured with fixed HHD will likely be more accurate for adults and individuals with greater strength, while HHD alone will be more consistent for individuals with lower strength. Muscle Nerve 56: 896-900, 2017.

Cited by 21 publications

References 24 publications

Comparison of Methods for Evaluating Upper Limb Strength by Hand-Held Dynamometry

Comparison of Methods for Evaluating Upper Limb Strength by Hand-Held Dynamometry

Isometric muscle strength in children and adolescents using Handheld dynamometry: reliability and normative data for the Brazilian population

Development of Lower Extremity Strength in Ambulatory Children With Bilateral Spastic Cerebral Palsy in Comparison With Typically Developing Controls Using Absolute and Normalized to Body Weight Force Values

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