Reliability of muscle strength assessment in chronic post-stroke hemiparesis: a systematic review and meta-analysis

Abstract

Background: Muscle weakness is the main cause of motor impairment among stroke survivors and is associated with reduced peak muscle torque.

Objective: To systematically investigate and organize the evidence of the reliability of muscle strength evaluation measures in post-stroke survivors with chronic hemiparesis.

Data sources: Two assessors independently searched four electronic databases in January 2014 (Medline, Scielo, CINAHL, Embase).

Study selection: Inclusion criteria comprised studies on reliability on muscle strength assessment in adult post-stroke patients with chronic hemiparesis.

Data extraction: We extracted outcomes from included studies about reliability data, measured by intraclass correlation coefficient (ICC) and/or similar. The meta-analyses were conducted only with isokinetic data.

Results: Of 450 articles, eight articles were included for this review. After quality analysis, two studies were considered of high quality. Five different joints were analyzed within the included studies (knee, hip, ankle, shoulder, and elbow). Their reliability results varying from low to very high reliability (ICCs from 0.48 to 0.99). Results of meta-analysis for knee extension varying from high to very high reliability (pooled ICCs from 0.89 to 0.97), for knee flexion varying from high to very high reliability (pooled ICCs from 0.84 to 0.91) and for ankle plantar flexion showed high reliability (pooled ICC = 0.85).

Conclusion: Objective muscle strength assessment can be reliably used in lower and upper extremities in post-stroke patients with chronic hemiparesis.

Keywords: Intraclass correlation coefficient; Isokinetic dynamometer; Knee; Strength; Stroke.