Assessment of Lower Limb Muscle Strength and Power Using Hand-Held and Fixed Dynamometry: A Reliability and Validity Study

Benjamin F Mentiplay, Luke G Perraton, Kelly J Bower, Brooke Adair, Yong-Hao Pua, Gavin P Williams, Rebekah McGaw, Ross A Clark, Benjamin F Mentiplay, Luke G Perraton, Kelly J Bower, Brooke Adair, Yong-Hao Pua, Gavin P Williams, Rebekah McGaw, Ross A Clark

Abstract

Introduction: Hand-held dynamometry (HHD) has never previously been used to examine isometric muscle power. Rate of force development (RFD) is often used for muscle power assessment, however no consensus currently exists on the most appropriate method of calculation. The aim of this study was to examine the reliability of different algorithms for RFD calculation and to examine the intra-rater, inter-rater, and inter-device reliability of HHD as well as the concurrent validity of HHD for the assessment of isometric lower limb muscle strength and power.

Methods: 30 healthy young adults (age: 23±5 yrs, male: 15) were assessed on two sessions. Isometric muscle strength and power were measured using peak force and RFD respectively using two HHDs (Lafayette Model-01165 and Hoggan microFET2) and a criterion-reference KinCom dynamometer. Statistical analysis of reliability and validity comprised intraclass correlation coefficients (ICC), Pearson correlations, concordance correlations, standard error of measurement, and minimal detectable change.

Results: Comparison of RFD methods revealed that a peak 200 ms moving window algorithm provided optimal reliability results. Intra-rater, inter-rater, and inter-device reliability analysis of peak force and RFD revealed mostly good to excellent reliability (coefficients ≥ 0.70) for all muscle groups. Concurrent validity analysis showed moderate to excellent relationships between HHD and fixed dynamometry for the hip and knee (ICCs ≥ 0.70) for both peak force and RFD, with mostly poor to good results shown for the ankle muscles (ICCs = 0.31-0.79).

Conclusions: Hand-held dynamometry has good to excellent reliability and validity for most measures of isometric lower limb strength and power in a healthy population, particularly for proximal muscle groups. To aid implementation we have created freely available software to extract these variables from data stored on the Lafayette device. Future research should examine the reliability and validity of these variables in clinical populations.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Testing positions for strength and…
Fig 1. Testing positions for strength and power assessment.
Note: Same positions were used on the fixed dynamometer. (A) Hip flexors with the participant seated and hips and knees flexed at 90°. Dynamometer placed on the anterior aspect of the thigh, proximal to the knee joint. (B) Knee extensors with the participant seated and hip and knees flexed at 90°. Dynamometer placed on the anterior aspect of the shank, proximal to the ankle joint. (C) Knee flexors with the participant seated and hips and knees flexed at 90°. Dynamometer placed on the posterior aspect of the shank, proximal to the ankle joint. (D) Ankle plantarflexors with the participant lying supine with the ankle in plantargrade and hips and knees extended. Dynamometer placed over the metatarsal heads on the sole of the foot. (E) Ankle dorsiflexors with the participant lying supine with the ankle relaxed and hips and knees extended. Dynamometer placed over the metatarsal heads on the dorsum of the foot. (F) Hip abductors with the participant lying supine and hips and knees extended. Dynamometer placed on the lateral aspect of the shank, proximal to the ankle joint. (G) Hip adductors with the participant lying supine and hips and knees extended. Dynamometer placed on the medial aspect of the shank, proximal to the ankle joint. (H) Hip extensors with the participant lying prone and hips and knees extended. Dynamometer placed on the posterior aspect of the shank, proximal to the ankle joint.

References

    1. Bohannon RW, Walsh S. Nature, reliability, and predictive value of muscle performance measures in patients with hemiparesis following stroke. Arch Phys Med Rehabil. 1992;73(8):721–5.
    1. Doherty TJ. Invited review: aging and sarcopenia. J Appl Physiol. 2003;95(4):1717–27.
    1. Gerrits KH, Beltman MJ, Koppe PA, Konijnenbelt H, Elich PD, de Haan A et al. Isometric muscle function of knee extensors and the relation with functional performance in patients with stroke. Arch Phys Med Rehabil. 2009;90(3):480–7. 10.1016/j.apmr.2008.09.562
    1. Wiley ME, Damiano DL. Lower-extremity strength profiles in spastic cerebral palsy. Dev Med Child Neurol. 1998;40(2):100–7.
    1. Aagaard P, Simonsen EB, Andersen JL, Magnusson P, Dyhre-Poulsen P. Increased rate of force development and neural drive of human skeletal muscle following resistance training. J Appl Physiol. 2002;93(4):1318–26.
    1. Caserotti P, Aagaard P, Buttrup Larsen J, Puggaard L. Explosive heavy-resistance training in old and very old adults: Changes in rapid muscle force, strength and power. Scand J Med Sci Sports. 2008;18(6):773–82. 10.1111/j.1600-0838.2007.00732.x
    1. Aagaard P, Suetta C, Caserotti P, Magnusson SP, Kjær M. Role of the nervous system in sarcopenia and muscle atrophy with aging: Strength training as a countermeasure. Scand J Med Sci Sports. 2010;20(1):49–64. 10.1111/j.1600-0838.2009.01084.x
    1. Fimland MS, Moen PMR, Hill T, Gjellesvik TI, Tørhaug T, Helgerud J et al. Neuromuscular performance of paretic versus non-paretic plantar flexors after stroke. Eur J Appl Physiol. 2011;111(12):3041–9. 10.1007/s00421-011-1934-z
    1. Fleming BE, Wilson DR, Pendergast DR. A portable, easily performed muscle power test and its association with falls by elderly persons. Arch Phys Med Rehabil. 1991;72(11):886–9.
    1. Izquierdo M, Aguado X, Gonzalez R, López JL, Häkkinen K. Maximal and explosive force production capacity and balance performance in men of different ages. Eur J Appl Physiol. 1999;79(3):260–7.
    1. Maffiuletti NA, Bizzini M, Widler K, Munzinger U. Asymmetry in quadriceps rate of force development as a functional outcome measure in TKA. Clin Orthop. 2010;468(1):191–8. 10.1007/s11999-009-0978-4
    1. Moreau NG, Falvo MJ, Damiano DL. Rapid force generation is impaired in cerebral palsy and is related to decreased muscle size and functional mobility. Gait Posture. 2012;35(1):154–8. 10.1016/j.gaitpost.2011.08.027
    1. Winters JD, Rudolph KS. Quadriceps rate of force development affects gait and function in people with knee osteoarthritis. Eur J Appl Physiol. 2014;114(2):273–84. 10.1007/s00421-013-2759-8
    1. Andersen LL, Aagaard P. Influence of maximal muscle strength and intrinsic muscle contractile properties on contractile rate of force development. Eur J Appl Physiol. 2006;96(1):46–52.
    1. Suetta C, Aagaard P, Rosted A, Jakobsen AK, Duus B, Kjaer M et al. Training-induced changes in muscle CSA, muscle strength, EMG, and rate of force development in elderly subjects after long-term unilateral disuse. J Appl Physiol. 2004;97(5):1954–61.
    1. Andersen LL, Andersen JL, Zebis MK, Aagaard P. Early and late rate of force development: Differential adaptive responses to resistance training? Scand J Med Sci Sports. 2010;20(1):e162–e9. 10.1111/j.1600-0838.2009.00933.x
    1. Blazevich AJ, Horne S, Cannavan D, Coleman DR, Aagaard P. Effect of contraction mode of slow-speed resistance training on the maximum rate of force development in the human quadriceps. Muscle Nerve. 2008;38(3):1133–46. 10.1002/mus.21021
    1. Pijnappels M, van der Burg JCE, Reeves ND, van Dieën JH. Identification of elderly fallers by muscle strength measures. Eur J Appl Physiol. 2008;102(5):585–92.
    1. Bemben MG, Massey BH, Bemben DA, Misner JE, Boileau RA. Isometric muscle force production as a function of age in healthy 20- to 74-yr-old men. Med Sci Sports Exerc. 1991;23(11):1302–10.
    1. Korhonen MT, Cristea A, Alén M, Häkkinen K, Sipilä S, Mero A et al. Aging, muscle fiber type, and contractile function in sprint-trained athletes. J Appl Physiol. 2006;101(3):906–17.
    1. Kyröläinen H, Avela J, McBride JM, Koskinen S, Andersen JL, Sipilä S et al. Effects of power training on muscle structure and neuromuscular performance. Scand J Med Sci Sports. 2005;15(1):58–64.
    1. Sleivert GG, Wenger HA. Reliability of measuring isometric and isokinetic peak torque, rate of torque development, integrated electromyography, and tibial nerve conduction velocity. Arch Phys Med Rehabil. 1994;75(12):1315–21.
    1. Kolber MJ, Cleland JA. Strength testing using hand-held dynamometry. Phys Ther Rev. 2005;10(2):99–112.
    1. Moriello C, Mayo NE. Development of a position-specific index of muscle strength to be used in stroke evaluation. Arch Phys Med Rehabil. 2006;87(11):1490–5.
    1. Stark T, Walker B, Phillips JK, Fejer R, Beck R. Hand-held dynamometry correlation with the gold standard isokinetic dynamometry: A systematic review. PM R. 2011;3(5):472–9. 10.1016/j.pmrj.2010.10.025
    1. Alemany JA, Pandorf CE, Montain SJ, Castellani JW, Tuckow AP, Nindl BC. Reliability assessment of ballistic jump squats and bench throws. J Strength Cond Res. 2005;19(1):33–8.
    1. Garnacho-Castaño MV, López-Lastra S, Maté-Muñoz JL. Reliability and validity assessment of a linear position transducer. J Sports Sci Med. 2015;14(1):128–36.
    1. Villadsen A, Roos EM, Overgaard S, Holsgaard-Larsen A. Agreement and reliability of functional performance and muscle power in patients with advanced osteoarthritis of the hip or knee. Am J Phys Med Rehabil. 2012;91(5):401–10. 10.1097/PHM.0b013e3182465ed0
    1. Bassey EJ, Fiatarone MA, O'Neill EF, Kelly M, Evans WJ, Lipsitz LA. Leg extensor power and functional performance in very old men and women. Clin Sci. 1992;82(3):321–7.
    1. Skelton DA, Kennedy J, Rutherford OM. Explosive power and asymmetry in leg muscle function in frequent fallers and non-fallers aged over 65. Age Ageing. 2002;31(2):119–25.
    1. Davies CTM, White MJ, Young K. Electrically evoked and voluntary maximal isometric tension in relation to dynamic muscle performance in elderly male subjects, aged 69 years. Eur J Appl Physiol. 1983;51(1):37–43.
    1. McMaster DT, Gill N, Cronin J, McGuigan M. A brief review of strength and ballistic assessment methodologies in sport. Sports Med. 2014;44(5):603–23. 10.1007/s40279-014-0145-2
    1. Trudelle-Jackson E, Jackson AW, Frankowski CM, Long KM, Meske NB. Interdevice reliability and validity assessment of the Nicholas Hand-Held Dynamometer. J Orthop Sports Phys Ther. 1994;20(6):302–6.
    1. Bohannon RW. Hand-held dynamometry: A practicable alternative for obtaining objective measures of muscle strength. Isokinet Exerc Sci. 2012;20(4):301–15.
    1. Foldvari M, Clark M, Laviolette LC, Bernstein MA, Kaliton D, Castaneda C et al. Association of muscle power with functional status in community-dwelling elderly women. J Gerontol A Biol Sci Med Sci. 2000;55(4):M192–M9.
    1. Thorborg K, Petersen J, Magnusson SP, Hölmich P. Clinical assessment of hip strength using a hand-held dynamometer is reliable. Scand J Med Sci Sports. 2010;20(3):493–501. 10.1111/j.1600-0838.2009.00958.x
    1. Bohannon RW. Test-retest reliabilty of hand-held dynamometry during a single session of strength assessment. Phys Ther. 1986;66(2):206–8.
    1. Portney LG, Watkins MP. Foundations of clinical research: applications to practice. 3rd ed ed. Upper Saddle River, New Jersey: Pearson/Prentice-Hall; 2009.
    1. Ludbrook J. Confidence in Altman-Bland plots: a critical review of the method of differences. Clin Exp Pharmacol Physiol. 2010;37(2):143–9. 10.1111/j.1440-1681.2009.05288.x
    1. Terwee CB, Mokkink LB, Knol DL, Ostelo RWJG, Bouter LM, De Vet HCW. Rating the methodological quality in systematic reviews of studies on measurement properties: A scoring system for the COSMIN checklist. Qual Life Res. 2012;21(4):651–7. 10.1007/s11136-011-9960-1
    1. Bandinelli S, Benvenuti E, Del Lungo I, Baccini M, Benvenuti F, Di Iorio A et al. Measuring muscular strength of the lower limbs by hand-held dynamometer: a standard protocol. Aging Clin Exp Res. 1999;11(5):287–93.
    1. Malliaras P, Hogan A, Nawrocki A, Crossley K, Schache A. Hip flexibility and strength measures: reliability and association with athletic groin pain. Br J Sports Med. 2009;43(10):739–44. 10.1136/bjsm.2008.055749
    1. Poulsen E, Christensen HW, Penny JØ, Overgaard S, Vach W, Hartvigsen J. Reproducibility of range of motion and muscle strength measurements in patients with hip osteoarthritis: an inter-rater study. BMC Musculoskelet Disord. 2012;13:242 10.1186/1471-2474-13-242
    1. Vanpee G, Segers J, Van Mechelen H, Wouters P, Van Den Berghe G, Hermans G et al. The interobserver agreement of handheld dynamometry for muscle strength assessment in critically ill patients. Crit Care Med. 2011;39(8):1929–34. 10.1097/CCM.0b013e31821f050b
    1. Richardson J, Stratford P, Cripps D. Assessment of reliability of the hand-held dynamometer for measuring strength in healthy older adults. Physiother Theory Pract. 1998;14(1):49–54.
    1. Kelln BM, McKeon PO, Gontkof LM, Hertel J. Hand-held dynamometry: Reliability of lower extremity muscle testing in healthy, physically active, young adults. J Sport Rehabil. 2008;17(2):160–70.
    1. Wikholm JB, Bohannon RW. Hand-held dynamometer measurements: Tester strength makes a difference. J Orthop Sports Phys Ther. 1991;13(4):191–8.
    1. Arnold CM, Warkentin KD, Chilibeck PD, Magnus CRA. The reliability and validity of handheld dynamometry for the measurement of lower-extremity muscle strength in older adults. J Strength Cond Res. 2010;24(3):815–24. 10.1519/JSC.0b013e3181aa36b8
    1. Fulcher ML, Hanna CM, Raina Elley C. Reliability of handheld dynamometry in assessment of hip strength in adult male football players. J Sci Med Sport. 2010;13(1):80–4. 10.1016/j.jsams.2008.11.007
    1. Taylor NF, Dodd KJ, Graham HK. Test-retest reliability of hand-held dynamometric strength testing in young people with cerebral palsy. Arch Phys Med Rehabil. 2004;85(1):77–80.
    1. Marmon AR, Pozzi F, Alnahdi AH, Zeni JA. The validity of plantarflexor strength measures obtained through hand-held dynamometry measurements of force. Int J Sports Phys Ther. 2013;8(6):820–7.
    1. Winter DA. Energy generation and absorption at the ankle and knee during fast, natural, and slow cadences. Clin Orthop. 1983;175:147–54.
    1. Mentiplay BF, Adair B, Bower KJ, Williams G, Tole G, Clark RA. Associations between lower limb strength and gait velocity following stroke: A systematic review. Brain Inj. 2015;29(4):409–22. 10.3109/02699052.2014.995231
    1. Kaminski TW, Perrin DH, Mattacola CG, Szczerba JE, Bernier JN. The reliability and validity of ankle inversion and eversion torque measurements from the Kin Com II isokinetic dynamometer. J Sport Rehabil. 1995;4(3):210–8.
    1. Pua YH, Wrigley TW, Cowan SM, Bennell KL. Intrarater test-retest reliability of hip range of motion and hip muscle strength measurements in persons with hip osteoarthritis. Arch Phys Med Rehabil. 2008;89(6):1146–54. 10.1016/j.apmr.2007.10.028

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj