Hand-held dynamometry: tester strength is paramount, even in frail populations

Stone, Carol; Nolan, Bríd; Lawlor, Peter G.; Kenny, Rose Anne

doi:10.2340/16501977-0860

Cited by 39 publications

(29 citation statements)

References 12 publications

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“…Inter-rater reliability of quadriceps strength testing was lower compared to other studies with the same test protocol (ICCs 0.80-0.85) [1,21]. However, samples in these studies consisted of patients with advanced cancer or elderly and consequently maximum strength assessed in these groups was considerably lower; 200 and 218 N respectively, compared to the current study [1,21].…”

contrasting

confidence: 78%

“…A handheld dynamometer (HHD) is often used to assess muscle strength, because it is a convenient and relatively inexpensive method [15]. The inter-rater reliability of quadriceps strength testing with HDD shows conflicting results and has not yet been tested in patients with PFPS [1,2,12,21,27]. To test sensitization, the pressure pain threshold (PPT) test can be used.…”

Section: Introduction ▼mentioning

confidence: 99%

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Strength and Pain Threshold Handheld Dynamometry Test Reliability in Patellofemoral Pain

et al. 2015

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Patellofemoral pain syndrome (PFPS), characterized by peri- and retropatellar pain, is a common disorder in young, active people. The etiology is unclear; however, quadriceps strength seems to be a contributing factor, and sensitization might play a role. The study purpose is determining the inter-rater reliability of handheld dynamometry to test both quadriceps strength and pressure pain threshold (PPT), a measure for sensitization, in patients with PFPS. This cross-sectional case-control study comprises 3 quadriceps strength and one PPT measurements performed by 2 independent investigators in 22 PFPS patients and 16 matched controls. Inter-rater reliability was analyzed using intraclass correlation coefficients (ICC) and Bland-Altman plots. Inter-rater reliability of quadriceps strength testing was fair to good in PFPS patients (ICC=0.72) and controls (ICC=0.63). Bland-Altman plots showed an increased difference between assessors when average quadriceps strength values exceeded 250 N. Inter-rater reliability of PPT was excellent in patients (ICC=0.79) and fair to good in controls (ICC=0.52). Handheld dynamometry seems to be a reliable method to test both quadriceps strength and PPT in PFPS patients. Inter-rater reliability was higher in PFPS patients compared to control subjects. With regard to quadriceps testing, a higher variance between assessors occurs when quadriceps strength increases.

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confidence: 78%

Section: Introduction ▼mentioning

confidence: 99%

Strength and Pain Threshold Handheld Dynamometry Test Reliability in Patellofemoral Pain

et al. 2015

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“…The measurement error of the HHD has been reported to be due to lack of stabilization15 ) and inadequate tester strength16, 17 ) . Inconsistent participant effort levels contributed to the measurement error.…”

Section: Discussionmentioning

confidence: 99%

Intra- and inter-rater reliability of isometric shoulder extensor and internal rotator strength measurements performed using a hand-held dynamometer

et al. 2016

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[Purpose] The purpose of the present study was to establish the intra- and inter-rater reliability of measurement of extensor strength in the maximum shoulder abducted position and internal rotator strength in the 90° abducted and the 90° external rotated position using a hand-held dynamometer. [Subjects and Methods] Twelve healthy volunteers (12 male; mean ± SD: age 19.0 ± 1.1 years) participated in the study. The examiners were two students who had nonclinical experience with a hand-held dynamometer measurement. The examiners and participants were blinded to measurement results by the recorder. Participants in the prone position were instructed to hold the contraction against the ground reaction force, and peak isometric force was recorded using the hand-held dynamometer on the floor. Reliability was determined using intraclass correlation coefficients. [Results] The intra- and inter-rater reliability data were found to be “almost perfect”. [Conclusion] This study investigated intra- and inter-rater reliability and reveald high reliability. Thus, the measurement method used in the present study can evaluate muscle strength by a simple measurement technique.

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“…Even though handheld dynamometers have good reliability in different populations, they have some important limitations such as difficulty in stabilizing the subject, and they are influenced by the strength of the examiner especially for large muscle groups. 17,18 The concept of using a simple strain-gauge uniaxial load cell device has been proposed before but it has not been tested in who live in residential care communities. 19 A uniaxial load cell device provides an easy and reliable way to overcome the aforementioned drawbacks and quantify muscle strength in different settings outside the clinic.…”

Section: Introductionmentioning

confidence: 99%

Standing balance and strength measurements in older adults living in residential care communities

et al. 2016

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Research on balance and mobility in older adults has been conducted primarily in lab-based settings in individuals who live in the community. Although they are at greater risk of falls, residents of long-term care facilities, specifically residential care communities (RCCs), have been investigated much less frequently. We sought to determine the feasibility of using portable technology-based measures of balance and muscle strength (i.e. an accelerometer and a load cell) that can be used in any RCC facility. Twenty-nine subjects (age 87±6 years) living in RCCs participated. An accelerometer placed on the back of the subjects measured body sway during different standing conditions. Sway in antero-posterior and medio-lateral directions were calculated. Lower extremity strength was measured with a portable load cell and the within-visit reliability was determined. Assessments of grip strength, gait speed, frailty, and comorbidity were also examined. A significant increase in postural sway in both the AP and ML directions occurred as the balance conditions became more difficult due to alteration of sensory feedback (p < 0.001) or reducing the base of support (p < 0.001). There was an association between increased sway and increased frailty, more comorbidities and slower gait speed. All strength measurements were highly reliable (ICC = 0.93 to 0.99).An increase in lower extremity strength was associated with increased grip strength and gait speed. The portable instruments provide inexpensive ways for measuring balance and strength in the understudied RCC population, but additional studies are needed to examine their relationship with functional outcomes.

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Hand-held dynamometry: tester strength is paramount, even in frail populations

Cited by 39 publications

References 12 publications

Strength and Pain Threshold Handheld Dynamometry Test Reliability in Patellofemoral Pain

Strength and Pain Threshold Handheld Dynamometry Test Reliability in Patellofemoral Pain

Intra- and inter-rater reliability of isometric shoulder extensor and internal rotator strength measurements performed using a hand-held dynamometer

Standing balance and strength measurements in older adults living in residential care communities

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