Test-retest Reliability of Isometric Knee Extension Muscle Strength Measurement using a Hand-held Dynamometer and a Belt: Study of Hemiplegic Patients

Abstract

Abstract.[Purpose] The purpose of this research was to study the test-retest reliability of three continuous sets of measurements of isometric knee extension muscle strength of hemiplegic patients, using a handheld dynamometer (HHD) and a belt.[Subjects] The subjects were 26 hospitalized hemiplegic patients (12 men, 14 women) with an average age of 62.4 years.[Method] The subjects sat on a mat table, and three sets of measurements were taken, at intervals of 30 seconds, of isometric knee extension muscle strength with the knee joint at a flexion angle of 90 degrees using an HHD and a belt. The measurements were also taken in a second session on a different day. Reliability was examined using the intraclass correlation coefficient (ICC (1,1)) and multiple comparison as a post-hoc test of one-way variance through repeated measurement.[Results] The ICC of the measurement values taken on the same day on the paralyzed side was 0.98, while in Session 2 it was 0.99; on the non-paralyzed side, it was 0.98 in Session 1 and in Session 2 it was 0.99. On the paralyzed side, main effect was seen in Session 2; the values of the first measurement were significantly smaller than the values of the second and third measurements. And, the highest values were obtained from the third measurement.[Conclusion] The ICC results show the test-retest reliability was high in both sessions. We thought it would be sufficient for measurements to be conducted three times, taking the highest values of those three.

Validity of Isometric Muscle Strength Measurements of the Lower Limbs Using a Hand-held Dynamometer and Belt: a Comparison with an Isokinetic Dynamometer

“…Multiple comparison (Bonferroni) analysis indicated the 1st measurement in session 2 for the paralyzed side was significantly lower than the 2nd and 3rd measurements 15) . The validity of measurements obtained with a HHD in comparison with those obtained with an isokinetic dynamometer (IKD) has been reported in various studies 8,[16][17][18][19] , however, to the best of our knowledge, there are no reports on the validity of such comparative measurements obtained with a HHD and belt [12][13][14][15] . Therefore, the purpose of this study was to investigate the validity (instrumental validity) of isometric muscle strength measurements of the hips and lower limbs obtained with a HHD and belt by comparing them with those obtained with an IKD.…”

“…The limit of the manual resistance was reported to be from 220 to 294.2 N (30 kg) in previous studies [1][2][3][4][5][6] . Methods previously reported for fixing a HHD to overcome this problem and prevent the angle of the joint from changing include using a stick 7) , a steel support 8) , and a belt [9][10][11][12][13][14][15] . Among these studies, Katoh et al 12,13) used a belt to help steady the HDD and investigated the reliability of isometric muscle strength measurements of the lower limbs (flexion, extension, abduction, adduction, internal rotation and external rotation of the hip, flexion and extension of the knee, and dorsiflexion and plantar flexion of the ankle), in healthy men and women with a mean age of 20 years.…”

“…The measurements were significantly higher (paired t-test: p<0.05) when the belt was used 12) . Katoh et al 14,15) also investigated the reliability of isometric muscle strength measurements of knee extension using the HHD and belt of elderly subjects and hemiplegic patients. In the latter, ICC (1,1), obtained as above, was 0.91 for males and 0.88 for females, but the second values within the pairs of measurements were significantly higher than those of the first values (paired t-test: p<0.05) 14) .…”

Reliability of Isometric Knee Extension Muscle Strength Measurements of Healthy Elderly Subjects Made with a Hand-held Dynamometer and a Belt

“…The test-retest reproducibility of measurements of isometric knee extension muscle strength has also been estimated for hemiplegic patients, for patients who had received surgery for femoral head fractures, and for healthy elderly people 46 , 47 , 48 ) . The ICCs (1, 1) for hemiplegic patients, obtained from 3 measurements performed on the same day were 0.98 for session 1 and 0.99 for session 2 on both the paralyzed and non-paralyzed sides 46 ) . For patients who had received surgery for femoral head fractures, the ICCs (1, 1) on the same day were 0.948 for the fractured leg, 0.953 for the non-fractured leg and 0.961 for the average of both legs 47 ) .…”

An Investigation into Reliability of Knee Extension Muscle Strength Measurements, and into the Relationship between Muscle Strength and Means of Independent Mobility in the Ward: Examinations of Patients Who Underwent Femoral Neck Fracture Surgery

“…For healthy young subjects, ICCs (1, 1) with two measurements were investigated in three segments (morning, afternoon, and one week later), and the results were values of 0.94, 0.96, 0.968 ) . In healthy elderly people, ICCs (1, 1) of two measurements were 0.91 for males and 0.88 for females10 ) , and in hemiplegic subjects, ICCs (1, 1) of three measurements were 0.98 in Session 1 and 0.99 in Session 2 on the paralyzed side, and 0.98 in Session 1 and 0.99 in Session 2 on the non-paralyzed side11 ) . We consider that ICCs values obtained in the present study are similar to those obtained in previous studies.…”