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Observational Study
. 2019 Jul 8;20(1):320.
doi: 10.1186/s12891-019-2703-0.

Reliability and validity of knee extensor strength measurements using a portable dynamometer anchoring system in a supine position

Kwan-Sik Sung  1 , You Gyoung Yi  2 , Hyung-Ik Shin  3
Affiliations
Observational Study

Reliability and validity of knee extensor strength measurements using a portable dynamometer anchoring system in a supine position

Kwan-Sik Sung et al. BMC Musculoskelet Disord. .

Abstract

Background: Muscle strength measurements using hand-held dynamometry (HHD) can be affected by the inadequate strength of the tester and lack of stabilization of the participants and the device. A portable HHD anchoring system was designed that enabled the measurement of isometric knee extensor muscle strength in a supine position. This can be used with individuals who are unable to assume the sitting position required for the measurement of knee extensor strength in conventional isokinetic dynamometry (IKD). The aim of this study was to evaluate the reliability and validity of knee extensor strength measurements using this device.

Methods: The maximal knee extensor isometric strength of the dominant leg in healthy adults aged 20 to 40 years was tested. Three trials of three contractions were assessed by two raters using the portable dynamometer anchoring system whilst the participant was in the supine position. After the three measurement trials, peak knee extensor torque was evaluated using IKD. The intraclass correlation coefficient (ICC) and 95% limits of agreement (LOA) for intra- and inter-rater reliability were obtained.

Results: Thirty-nine participants (19 male and 20 female, aged 30.08 ± 4.16 y), completed the three measurement trials. The ICC for intra-rater reliability was 0.98 for the maximum measurements of knee extensor strength (95% confidence interval [CI]: 0.96-0.98) and 0.98 (95% CI: 0.96-0.99) for inter-rater reliability. The mean difference (%) between the maximum knee extensor strength measurements of each trial was 1.02% (LOA range: - 11.13 to 13.16%) for intra-rater and - 1.44% (LOA range: - 13.98 to 11.08%) for inter-rater measurements. The Pearson correlation coefficient of the maximum voluntary peak torque measurements with the portable dynamometer anchoring system and IKD was 0.927.

Conclusions: The portable dynamometer anchoring system is a reliable and valid tool for measuring isometric knee extensor strength in a supine position. Future clinical feasibility studies are needed to determine if this equipment can be applied to people with severe illness or disabilities.

Trial registration: KCT0003041 .

Keywords: Hand-held dynamometry; Portable dynamometer anchoring system; Supine.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The portable dynamometer anchoring system. (a) The portable dynamometer anchoring system for measuring supine isometric knee extensor strength. A: Movable frame that can adjust the placement of the hand-held dynamometer (HHD) according to the size of the lower leg. B: Movable frame that can adjust the HHD placement according to leg length. C: Belt to fix the anchoring system to the bed. (b) Position of the examiner to prevent pelvic rotation of the participant
Fig. 2
Fig. 2
Bland and Altman plot for intra-rater measurements. (a) The mean difference and limits of agreement (LOA) between the maximum knee extensor strength measurements, (b) The mean difference (%) and LOA (%) between the maximum knee extensor strength measurements
Fig. 3
Fig. 3
Bland and Altman plot for inter-rater measurements. (a) The mean difference and limits of agreement (LOA) between the maximum knee extensor strength measurements, (b) The mean difference (%) and LOA (%) between the maximum knee extensor strength measurements
Fig. 4
Fig. 4
Correlation between maximal voluntary knee extensor torque obtained using the portable anchoring system and isokinetic dynamometer. r: Pearson correlation coefficient
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