Comparison of Common Methodologies for the Determination of Knee Flexor Muscle Strength

# Background Knee flexion strength may hold important clinical implications for the determination of injury risk and readiness to return to sport following injury and orthopedic surgery. A wide array of testing methodologies and positioning options are available that require validation prior to cli...

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Autores principales:	Dan I Ogborn, Alix Bellemare, Brittany Bruinooge, Holly Brown, Sheila McRae, Jeff Leiter
Formato:	article
Lenguaje:	EN
Publicado:	North American Sports Medicine Institute 2021
Materias:	Sports medicine RC1200-1245
Acceso en línea:	https://doaj.org/article/8c5a0c2920da4bba8461656042a4f4d0
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spelling	oai:doaj.org-article:8c5a0c2920da4bba8461656042a4f4d02021-12-02T16:01:46ZComparison of Common Methodologies for the Determination of Knee Flexor Muscle Strength10.26603/001c.213112159-2896https://doaj.org/article/8c5a0c2920da4bba8461656042a4f4d02021-04-01T00:00:00Zhttps://ijspt.scholasticahq.com/article/21311-comparison-of-common-methodologies-for-the-determination-of-knee-flexor-muscle-strength.pdfhttps://doaj.org/toc/2159-2896# Background Knee flexion strength may hold important clinical implications for the determination of injury risk and readiness to return to sport following injury and orthopedic surgery. A wide array of testing methodologies and positioning options are available that require validation prior to clinical integration. The purpose of this study was to 1) investigate the validity and test-retest reliability of isometric knee flexion strength measured by a fixed handheld dynamometer (HHD) apparatus compared to a Biodex Dynamometer (BD), 2) determine the impact of body position (seated versus supine) and foot position (plantar- vs dorsiflexed) on knee flexion peak torque and 3) establish the validity and test-retest reliability of the NordBord Hamstring Dynamometer. # Study Design Validity and reliability study, test-retest design. # Methods Forty-four healthy participants (aged 27 ± 4.8 years) were assessed by two raters over two testing sessions separated by three to seven days. Maximal isometric knee flexion in the seated and supine position at 90^o^ knee flexion was measured with both a BD and an externally fixed HHD with the foot held in maximal dorsiflexion or in plantar flexion. The validity and test-retest reliability of eccentric knee flexor strength on the NordBord hamstring dynamometer was assessed and compared with isometric strength on the BD. # Results Level of agreement between HHD and BD torque demonstrated low bias (bias -0.33 Nm, SD of bias 13.5 Nm; 95% LOA 26.13 Nm, -26.79 Nm). Interrater reliability of the HHD was high, varying slightly with body position (ICC range 0.9-0.97, n=44). Isometric knee flexion torque was higher in the seated versus supine position and with the foot dorsiflexed versus plantarflexed. Eccentric knee flexion torque had a high degree of correlation with isometric knee flexion torque as measured via the BD (r=0.61-0.86). The NordBord had high test-retest reliability (0.993 (95%CI 0.983-0.997, n=19) for eccentric knee flexor strength, with an MDC~95~ of 26.88 N and 28.76 N for the left and right limbs respectively. # Conclusion Common measures of maximal isometric knee flexion display high levels of correlation and test-retest reliability. However, values obtained by an externally fixed HHD are not interchangeable with values obtained via the BD. Foot and body position should be considered and controlled during testing. # Level of Evidence 2bDan I OgbornAlix BellemareBrittany BruinoogeHolly BrownSheila McRaeJeff LeiterNorth American Sports Medicine InstitutearticleSports medicineRC1200-1245ENInternational Journal of Sports Physical Therapy, Vol 16, Iss 2 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Sports medicine RC1200-1245
spellingShingle	Sports medicine RC1200-1245 Dan I Ogborn Alix Bellemare Brittany Bruinooge Holly Brown Sheila McRae Jeff Leiter Comparison of Common Methodologies for the Determination of Knee Flexor Muscle Strength
description	# Background Knee flexion strength may hold important clinical implications for the determination of injury risk and readiness to return to sport following injury and orthopedic surgery. A wide array of testing methodologies and positioning options are available that require validation prior to clinical integration. The purpose of this study was to 1) investigate the validity and test-retest reliability of isometric knee flexion strength measured by a fixed handheld dynamometer (HHD) apparatus compared to a Biodex Dynamometer (BD), 2) determine the impact of body position (seated versus supine) and foot position (plantar- vs dorsiflexed) on knee flexion peak torque and 3) establish the validity and test-retest reliability of the NordBord Hamstring Dynamometer. # Study Design Validity and reliability study, test-retest design. # Methods Forty-four healthy participants (aged 27 ± 4.8 years) were assessed by two raters over two testing sessions separated by three to seven days. Maximal isometric knee flexion in the seated and supine position at 90^o^ knee flexion was measured with both a BD and an externally fixed HHD with the foot held in maximal dorsiflexion or in plantar flexion. The validity and test-retest reliability of eccentric knee flexor strength on the NordBord hamstring dynamometer was assessed and compared with isometric strength on the BD. # Results Level of agreement between HHD and BD torque demonstrated low bias (bias -0.33 Nm, SD of bias 13.5 Nm; 95% LOA 26.13 Nm, -26.79 Nm). Interrater reliability of the HHD was high, varying slightly with body position (ICC range 0.9-0.97, n=44). Isometric knee flexion torque was higher in the seated versus supine position and with the foot dorsiflexed versus plantarflexed. Eccentric knee flexion torque had a high degree of correlation with isometric knee flexion torque as measured via the BD (r=0.61-0.86). The NordBord had high test-retest reliability (0.993 (95%CI 0.983-0.997, n=19) for eccentric knee flexor strength, with an MDC~95~ of 26.88 N and 28.76 N for the left and right limbs respectively. # Conclusion Common measures of maximal isometric knee flexion display high levels of correlation and test-retest reliability. However, values obtained by an externally fixed HHD are not interchangeable with values obtained via the BD. Foot and body position should be considered and controlled during testing. # Level of Evidence 2b
format	article
author	Dan I Ogborn Alix Bellemare Brittany Bruinooge Holly Brown Sheila McRae Jeff Leiter
author_facet	Dan I Ogborn Alix Bellemare Brittany Bruinooge Holly Brown Sheila McRae Jeff Leiter
author_sort	Dan I Ogborn
title	Comparison of Common Methodologies for the Determination of Knee Flexor Muscle Strength
title_short	Comparison of Common Methodologies for the Determination of Knee Flexor Muscle Strength
title_full	Comparison of Common Methodologies for the Determination of Knee Flexor Muscle Strength
title_fullStr	Comparison of Common Methodologies for the Determination of Knee Flexor Muscle Strength
title_full_unstemmed	Comparison of Common Methodologies for the Determination of Knee Flexor Muscle Strength
title_sort	comparison of common methodologies for the determination of knee flexor muscle strength
publisher	North American Sports Medicine Institute
publishDate	2021
url	https://doaj.org/article/8c5a0c2920da4bba8461656042a4f4d0
work_keys_str_mv	AT daniogborn comparisonofcommonmethodologiesforthedeterminationofkneeflexormusclestrength AT alixbellemare comparisonofcommonmethodologiesforthedeterminationofkneeflexormusclestrength AT brittanybruinooge comparisonofcommonmethodologiesforthedeterminationofkneeflexormusclestrength AT hollybrown comparisonofcommonmethodologiesforthedeterminationofkneeflexormusclestrength AT sheilamcrae comparisonofcommonmethodologiesforthedeterminationofkneeflexormusclestrength AT jeffleiter comparisonofcommonmethodologiesforthedeterminationofkneeflexormusclestrength
_version_	1718385285854658560

Comparison of Common Methodologies for the Determination of Knee Flexor Muscle Strength

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