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. 2019 Summer;71(3):231-238.
doi: 10.3138/ptc-2018-0051.

Investigating the Test-Retest Reliability and Validity of Hand-Held Dynamometry for Measuring Knee Strength in Older Women with Knee Osteoarthritis

Jaclyn N Chopp-Hurley  1   2 , Emily G Wiebenga  1   3 , Anthony A Gatti  1 , Monica R Maly  1   3   4
Affiliations

Investigating the Test-Retest Reliability and Validity of Hand-Held Dynamometry for Measuring Knee Strength in Older Women with Knee Osteoarthritis

Jaclyn N Chopp-Hurley et al. Physiother Can. 2019 Summer.

Abstract
in English, French

Purpose: Hand-held dynamometry (HHD) can be used to evaluate strength when gold-standard isokinetic dynamometry (IKD) is not feasible. HHD is useful for measuring lower limb strength in a healthy population; however, its reliability and validity in individuals with knee osteoarthritis (OA) has received little attention. In this research, we examined the test-retest reliability and validity of HHD in older women with knee OA. We also examined the associations between reliability and symptom and disease severity. Method: A total of 28 older women with knee OA completed knee extension and flexion exertions measured using HHD and IKD. Intra-class correlation coefficients (ICC2,3), standard error of measurement, and minimal detectable change were calculated. Correlation coefficients and regressions evaluated the relationships between inter-trial differences and symptom and disease severity. Results: High test-retest reliability was demonstrated for both exertions with each device (ICC2,3 = 0.83-0.96). Variance between trials was not correlated with OA symptoms. Criterion validity was good (ICC2,3 = 0.76), but extension yielded lower agreement than flexion. Regression analysis demonstrated that true strength can be predicted from HHD measurements. Conclusions: HHD is a reliable tool for capturing knee extension and flexion in individuals with OA. Because of lower agreement, HHD might be best suited for evaluating within-subject strength changes rather than true strength scores. However, gold-standard extension strength magnitudes may reasonably be predicted from regression equations (r 2 = 0.82).

Objectif : la dynamométrie portative (DP) peut évaluer la force lorsque la dynamométrie isocinétique (DIC) de référence n’est pas réalisable. La DP est utile pour mesurer la force des membres inférieurs dans une population en santé, mais on n’en a pas vraiment établi la fiabilité et la validité chez les personnes atteintes d’arthrose du genou. La présente étude a porté sur la fiabilité test–retest et la validité de la DP chez les femmes âgées atteintes d’arthrose du genou. Elle a également porté sur les associations entre la fiabilité et la gravité des symptômes et de la maladie. Méthodologie : au total, 28 femmes âgées atteintes d’arthrose du genou ont effectué des efforts d’extension et de flexion du genou, qui ont été mesurés par DP et DIC. Les chercheurs ont calculé les coefficients de corrélation intraclasse (CCI2,3), l’écart-type de mesure et le changement décelable minimal. Avec les coefficients de corrélation et la régression, ils ont évalué la relation entre les différences interessai et la gravité des symptômes et de la maladie. Résultats : les chercheurs ont démontré la haute fiabilité test–retest des deux appareils à l’effort (CCI2,3 = 0,83 à 0,96). L’écart entre les essais n’était pas corrélé avec les symptômes d’arthrose. Les critères avaient une bonne validité (CCI2,3 = 0,76), mais l’extension procurait une moins bonne concordance que la flexion. L’analyse de régression a démontré qu’il est possible de prédire la véritable force à l’aide des mesures de DP. Conclusion : la DP est un outil fiable pour mesurer l’extension et la flexion du genou chez les personnes atteintes d’arthrose. En raison de sa concordance plus faible, la DP convient peut-être mieux pour évaluer les changements de force intra-individuels plutôt que les véritables scores de force. Cependant, les équations de régression peuvent raisonnablement prédire l’amplitude de force de l’extension de référence (r 2 = 0,82).

Keywords: knee osteoarthritis; muscle strength dynamometer; reproducibility of results.

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Figures

Figure 1
Figure 1
Bland–Altman plots for (a) mean knee extension torque and (b) mean knee flexion torque. In each plot, the solid line represents the mean of all differences between the peak IKD torque and peak HHD torque. The dashed lines represent mean (95% CI, or 2 × SDs). The grey circles indicate differences beyond the 95% confidence limits.
Figure 1
Figure 1
Bland–Altman plots for (a) mean knee extension torque and (b) mean knee flexion torque. In each plot, the solid line represents the mean of all differences between the peak IKD torque and peak HHD torque. The dashed lines represent mean (95% CI, or 2 × SDs). The grey circles indicate differences beyond the 95% confidence limits.
See this image and copyright information in PMC

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