Reproducibility of isokinetic measures of the knee and ankle muscle strength in community-dwelling older adults without and with Alzheimer's disease

Abstract

Background: To interpret changes of muscle strength in older adults with Alzheimer's disease (AD), determining the reliability of outcome measures is necessary. Therefore, the purpose of the present study was to investigate the relative and absolute intra-rater reliability of concentric isokinetic measures of the knee and ankle muscle strength in community-dwelling older adults without and with AD in the mild and moderate stages.

Methods: A methodological study was conducted. The participants were submitted to two isokinetic evaluations with an interval of three to seven days. The evaluations consisted of knee extension and flexion at 60°/s (five repetitions) and 180°/s (15 repetitions) and plantar flexion and dorsiflexion of the ankle at 30°/s (five repetitions). The measures of interest were peak torque, average peak torque and total work. The intraclass correlation coefficient two-way mixed model of a single-measure (ICC_3,1), standard error of measurement (SEM) and minimal detectable change at the 95% confidence interval (MDC₉₅) were calculated. The ICC_3,1 was interpreted based on Munro's classification. Standard error of measurement and MDC₉₅ were analyzed in absolute and relative values (percentage of error [SEM%] and change [MDC₉₅%]).

Results: A total of 62 older adults were included and allocated to the three groups: mild-AD (n = 22, 79.9 years, 15 female and seven male), moderate-AD (n = 20, 81.6 years, 15 female and five male) and without-AD (n = 20, 74.3 years, 10 female and seven male). The ICCs_3,1 of the measures of knee were high/very high in the three groups (0.71-0.98). The ICCs_3,1 of the measures of ankle were high/very high in the mild-AD group (0.78-0.92), moderate/high/very high in the moderate-AD group (0.63-0.93) and high/very high in the group without-AD (0.84-0.97). The measurements of knee extensors at 60°/s, knee extensors (peak torque and total work), with the exception of peak torque in the mild-AD group, and flexors (average peak torque) at 180°/s, and ankle dorsiflexors at 30°/s had the lowest of SEM% and MDC95% in the three groups.

Conclusion: Concentric isokinetic measures are reliable for the assessment of knee and ankle muscle strength in community-dwelling older adults without and with AD in the mild and moderate stages.

Keywords: Aging; Alzheimer disease; Dementia; Muscle strength; Reproducibility of results.

Fig. 1

Flow diagram of participants